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Aceon: Uses, dosage, side effects, warnings & patient reviews

Aceon

Aceon
aceon 4 mg
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Aceon

Perindopril erbumine
Aceon is the brand name for the prescription medication perindopril erbumine. It belongs to the angiotensin-converting enzyme (ACE) inhibitor class and is indicated for the treatment of essential hypertension and for reducing the risk of cardiovascular events in patients with stable coronary artery disease.
  • ActiveIngredient: Perindopril erbumine
  • DosageForm: Oral tablets
  • Dosage: 2 mg, 4 mg, 8 mg
  • Indications: Treatment of essential hypertension; Treatment of stable coronary artery disease to reduce the risk of cardiovascular mortality or nonfatal myocardial infarction.
  • Manufacturer: Symplmed Pharmaceuticals (Brand); generic manufacturers include Teva Pharmaceuticals, Lupin Pharmaceuticals, and Aurobindo Pharma.
  • Storage: Store at room temperature 20°C–25°C (68°F–77°F); protect from moisture.
  • Drug Status: Prescription Only
Description

What is Aceon (Perindopril Erbumine)?

Aceon is a prescription medication containing the active ingredient perindopril erbumine. It belongs to a class of drugs known as angiotensin-converting enzyme (ACE) inhibitors. Aceon is primarily used to manage cardiovascular conditions, specifically essential hypertension (high blood pressure) and to reduce the risk of cardiovascular mortality or nonfatal myocardial infarction in patients with stable coronary artery disease. For more on cardiovascular conditions, see our resources on blood pressure treatments.

As an ACE inhibitor, perindopril works by inhibiting the enzyme responsible for converting angiotensin I to angiotensin II, a potent vasoconstrictor. This inhibition leads to relaxation of blood vessels, lowering peripheral vascular resistance and blood pressure without causing a significant increase in heart rate.

Aceon is available as tablets in several strengths: 2 mg, 4 mg, and 8 mg. Generic versions containing perindopril erbumine are also available.

General Instructions

How to Take Aceon

Administration

Aceon tablets are administered orally, typically once daily. It is recommended to take the medication at the same time each day to maintain consistent blood pressure control. Aceon can be taken with or without food.

Swallow the tablets with a sufficient amount of liquid. The tablets are scored; use the tablet strength and any splitting instructions exactly as directed by your healthcare provider or pharmacist.

Duration of Therapy

Hypertension and coronary artery disease are chronic conditions that usually require long-term management. Aceon helps control these conditions but does not cure them. Patients should continue taking the medication as prescribed, even if they feel well, unless advised otherwise by their healthcare provider. Stopping treatment without medical advice may reduce blood pressure control or interrupt proven risk reduction in stable coronary artery disease.

Missed Dose

If a dose is missed, take it as soon as remembered. If it is almost time for the next dose, skip the missed dose and resume the regular schedule. Do not double the dose to compensate for a missed one.

Side Effects

Side Effects of Aceon

As with all ACE inhibitors, Aceon can cause a range of side effects. The following table categorizes these effects based on clinical trial data and post-marketing experience. For a general understanding of medication side effects, refer to this guide.

Common and Serious Side Effects of Aceon (Perindopril)
FrequencySide EffectsNotes
Common
  • Persistent, dry cough
  • Dizziness, lightheadedness
  • Back pain
  • Fatigue
  • Hypotension (low blood pressure), particularly after initiation or dose increases
The dry cough is a class effect of ACE inhibitors and is related to bradykinin accumulation. It is a frequent reason for treatment discontinuation. For general information on symptom relief, see this resource, although ACE inhibitor cough often does not respond to standard cold remedies.
Less Common / Serious
  • Hyperkalemia (elevated serum potassium)
  • Increased serum creatinine, indicating renal impairment
  • Angioedema: swelling of the face, lips, tongue, or larynx
  • Symptomatic hypotension, especially in volume-depleted patients
  • Hepatitis or jaundice
Angioedema is a medical emergency. For general context on swelling and allergy-type symptoms, see the allergies category, although ACE inhibitor angioedema is not the same as a typical allergic reaction.
Uses

What is Aceon Used For?

Aceon is indicated for specific, FDA-approved medical conditions. It is not intended for use in patients with conditions for which it has not been evaluated.

Primary Medical Uses

  • Essential Hypertension: Aceon is indicated for the treatment of essential hypertension (high blood pressure) to lower blood pressure. Lowering blood pressure reduces the risk of fatal and nonfatal cardiovascular events, primarily strokes and myocardial infarctions. For detailed information on the condition, see our page on essential hypertension.
  • Stable Coronary Artery Disease: Aceon is indicated to reduce the risk of cardiovascular mortality or nonfatal myocardial infarction in patients with stable coronary artery disease. This indication is supported by outcome data in patients without clinical heart failure. Learn more about heart disease.

The choice to use Aceon and its dosage is determined by a healthcare provider based on a comprehensive assessment of the patient’s medical history, renal function, and electrolyte status.

Safety advice

Interactions Alcohol:

Use with caution
Alcohol can potentiate the vasodilatory effects of Aceon, leading to an additive drop in blood pressure and an increased risk of dizziness, lightheadedness, and syncope. Patients should be aware of the potential for orthostatic hypotension. For general information on blood pressure management, see this article.

Interactions Other Medications:

Consult your doctor
Significant interactions exist with nonsteroidal anti-inflammatory drugs (NSAIDs), which may reduce the antihypertensive effect and increase the risk of renal impairment, particularly in volume-depleted or elderly patients. For more on NSAID risks, refer to this guide. Concomitant use with potassium supplements, potassium-sparing diuretics, or salt substitutes increases the risk of hyperkalemia. Dual blockade of the renin-angiotensin system with aliskiren is contraindicated in patients with diabetes. Concomitant use with sacubitril/valsartan or another neprilysin inhibitor is contraindicated because of an increased risk of angioedema.

Special Groups Pregnancy:

Unsafe
Aceon carries a boxed warning for fetal toxicity. Drugs that act directly on the renin-angiotensin system can cause fetal and neonatal injury or death during pregnancy. When pregnancy is detected, Aceon should be discontinued as soon as possible. For more on medication use during pregnancy, see this guide.

Special Groups Breastfeeding:

Consult your doctor
Limited data are available on the excretion of perindopril in human milk. Because of the potential for adverse effects in the nursing infant, the decision about breastfeeding during treatment should be made with a healthcare professional, taking into account the importance of the drug to the mother.

Special Groups Elderly:

Use with caution
Elderly patients may have reduced renal function and may be more susceptible to the hypotensive effects of Aceon. A lower starting dose may be appropriate depending on the indication, age, and renal function, and monitoring should be closer during dose titration.

Special Groups Children:

Unsafe
Safety and effectiveness in pediatric patients have not been established. Aceon is not indicated for use in children.

Effects on Activities Driving:

Use with caution
Aceon may cause dizziness or hypotension, particularly after the first dose or following dose increases. Patients should assess their individual response before driving or engaging in tasks that require full alertness.

Effects on Activities Operating Machinery:

Use with caution
The same caution as for driving applies. Individuals should avoid operating hazardous machinery if they experience dizziness, lightheadedness, or syncope.
Concerns

Important Safety Concerns and Considerations

Fetal Toxicity (Boxed Warning)

As noted in the Safety Advice, Aceon carries a boxed warning regarding its use during pregnancy. Patients of childbearing potential should be counseled about the risks and the need for prompt reporting of pregnancy. When pregnancy is detected, Aceon should be discontinued as soon as possible.

Angioedema

Angioedema of the face, extremities, lips, tongue, glottis, and/or larynx has been reported in patients treated with ACE inhibitors, including perindopril. This can occur at any time during treatment. Patients with a history of angioedema unrelated to ACE inhibitor therapy may be at increased risk. Laryngeal angioedema can be fatal; emergency therapy, including securing the airway, is necessary. The incidence may be higher in Black patients compared to non-Black patients.

Hypotension and First-Dose Effect

Symptomatic hypotension is most likely to occur in patients who have been volume- or salt-depleted as a result of prolonged diuretic therapy, dietary salt restriction, dialysis, diarrhea, or vomiting. In these patients, initiating therapy with a lower dose or adjusting concomitant diuretic therapy may be considered. For more on cerebrovascular risks, see cerebrovascular disease.

Hyperkalemia

Aceon can cause hyperkalemia. Risk factors include renal impairment, diabetes, and the concomitant use of potassium-sparing diuretics, potassium supplements, or other drugs associated with increases in serum potassium. Serum potassium should be monitored periodically.

Renal Function Impairment

Use of Aceon may be associated with increases in blood urea nitrogen (BUN) and serum creatinine, especially in patients with renal artery stenosis, severe heart failure, or those receiving diuretics. Renal function should be monitored periodically. For more on renal considerations, see kidney disease.

Warnings

Critical Warnings for Aceon Use

Boxed Warning: Fetal Toxicity

When pregnancy is detected, Aceon should be discontinued as soon as possible. Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus.

Contraindications

  • Hypersensitivity: Known hypersensitivity to perindopril or any other ACE inhibitor, including ACE inhibitor-associated angioedema.
  • Hereditary or Idiopathic Angioedema: Aceon is contraindicated in patients with hereditary or idiopathic angioedema.
  • Concomitant Aliskiren Use in Diabetes: Do not co-administer aliskiren with Aceon in patients with diabetes.
  • Concomitant Neprilysin Inhibitor Use: Do not use Aceon together with a neprilysin inhibitor such as sacubitril. Allow at least 36 hours when switching to or from sacubitril/valsartan.

Dual Blockade of the Renin-Angiotensin System (RAS)

Combining Aceon with another RAS-blocking agent (e.g., an ARB like Cozaar) or aliskiren is generally not recommended, as it increases the risk of hypotension, hyperkalemia, and renal impairment. Dual blockade is contraindicated with aliskiren in patients with diabetes.

Anaphylactoid Reactions During Desensitization

Patients receiving ACE inhibitors during desensitization treatment with hymenoptera venom have experienced life-threatening anaphylactoid reactions.

Hepatic Failure

Rarely, ACE inhibitors have been associated with a syndrome that starts with cholestatic jaundice and progresses to fulminant hepatic necrosis and sometimes death. Patients who develop jaundice or marked elevations of hepatic enzymes should discontinue Aceon and seek medical evaluation.

Neutropenia/Agranulocytosis

Another ACE inhibitor (captopril) has been shown to cause agranulocytosis and bone marrow depression, more often in patients with renal impairment, especially those with collagen vascular disease. Monitoring of white blood cell counts may be considered in higher-risk patients.

Dosage

Aceon Dosage Information

Dosage must be individualized by the treating physician. The following table provides general guidelines based on the official prescribing information. These are not instructions for self-medication.

Aceon (Perindopril Erbumine) Dosage Guidelines for Adults
IndicationRecommended Starting DoseUsual Maintenance Dose
Essential Hypertension (in patients not receiving a diuretic)4 mg once daily4 mg to 8 mg once daily. The maximum dose studied was 16 mg/day, though experience at this dose is limited.
Essential Hypertension (in patients receiving a diuretic)4 mg once daily, with close monitoring for symptomatic hypotensionAs above, titrated based on response. Consider reducing the diuretic dose before starting Aceon.
Stable Coronary Artery Disease4 mg once daily for 2 weeks, then increased to 8 mg once daily, as tolerated8 mg once daily. In patients older than 70 years, dosing generally begins at 2 mg once daily in the first week, then 4 mg once daily in the second week, followed by 8 mg once daily if tolerated.
Patients with Renal ImpairmentFor creatinine clearance 30 mL/min or greater but reduced, 2 mg once daily may be used initiallyAdjust based on response and tolerance, with careful monitoring. Aceon is not recommended in patients with creatinine clearance below 30 mL/min.
Elderly PatientsFor hypertension, 4 mg once daily or less may be appropriate initially depending on renal function and tolerability4 mg to 8 mg once daily, with slower titration and closer monitoring as needed.

Important Notes

  • Onset of Effect: Blood pressure response should be assessed over time, especially just before the next dose when therapy is being titrated.
  • Concomitant Diuretics: Consider reducing the diuretic dose before initiating Aceon to reduce the risk of hypotension.
  • Dose Titration: Dosage should be adjusted based on blood pressure response, tolerability, renal function, and serum potassium.
Interactions

Drug Interactions with Aceon

Aceon interacts with numerous medications. A comprehensive medication review with a healthcare provider is important to reduce the risk of serious adverse effects.

Significant Drug Interactions with Aceon (Perindopril)
Interacting Substance Class / DrugEffect of InteractionClinical Recommendation
Diuretics (e.g., Lasix)Additive effect on blood pressure; increased risk of first-dose hypotension, especially in volume-depleted patients.Consider reducing the diuretic dose before starting Aceon. Monitor blood pressure closely.
Potassium-Sparing Diuretics, Potassium Supplements, Salt SubstitutesIncreased risk of hyperkalemia.Monitor serum potassium. Co-administration may require caution or may not be appropriate in some patients.
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)May reduce the antihypertensive effect and increase the risk of renal impairment, particularly in volume-depleted or elderly patients.Monitor blood pressure and renal function. Ensure adequate hydration. For NSAID risks, see this guide.
LithiumIncreased serum lithium concentrations and lithium toxicity have been reported.Monitor serum lithium levels frequently during concomitant use.
Dual RAS Blockade Agents (ARBs, Aliskiren)Increased risk of hypotension, hyperkalemia, and renal impairment. Contraindicated with aliskiren in patients with diabetes.Avoid combination unless there is a clear clinical reason. If used, monitor closely.
Neprilysin Inhibitors (e.g., sacubitril/valsartan)Increased risk of angioedema.Contraindicated together. Do not use within 36 hours of switching to or from sacubitril/valsartan.
PDE5 Inhibitors (e.g., sildenafil)Additive blood pressure-lowering effects may occur.Use with caution. Patients should be stable on their antihypertensive regimen before using PDE5 inhibitors.
FAQs
Yes, Aceon (perindopril erbumine) belongs to the class of medications known as angiotensin-converting enzyme (ACE) inhibitors. It works by inhibiting the conversion of angiotensin I to the vasoconstrictor angiotensin II, leading to blood vessel relaxation and lower blood pressure.
Aceon, lisinopril, and ramipril are all ACE inhibitors with similar mechanisms of action. Key differences include metabolism, dosing patterns, and the clinical evidence supporting specific uses. Perindopril has specific outcome data supporting its use in stable coronary artery disease. The choice between agents is made by a physician based on individual patient factors, tolerability, kidney function, and cost. If a persistent dry cough occurs with Aceon, a physician may consider switching to an ARB like Cozaar.
Concomitant use of Aceon with ibuprofen or other NSAIDs is generally not recommended without medical supervision. NSAIDs can reduce the blood pressure-lowering effects of Aceon and increase the risk of kidney damage, especially in patients who are elderly, volume-depleted, or have pre-existing renal impairment. Always consult a doctor before combining these medications.
Aceon is typically taken once daily. It can be taken in the morning or at another consistent time of day, but consistency is most important for maintaining stable treatment. Patients should follow their prescriber's recommendation and discuss timing based on blood pressure patterns, tolerance, and daily routine.
A persistent, dry cough is a well-known side effect of ACE inhibitors. It is not a sign of a lung infection. Over-the-counter cough suppressants are often ineffective for this type of cough. If the cough is bothersome, you should consult your doctor. They may consider an angiotensin II receptor blocker (ARB), such as losartan, which lowers blood pressure without typically causing an ACE inhibitor cough.
Other Details

Additional Information

Pharmacokinetics and Mechanism

Perindopril is a prodrug; approximately 20% of an oral dose is metabolized in the liver to perindoprilat, its active metabolite. Perindoprilat has significantly higher ACE-inhibitory activity than the parent compound. It has a long terminal elimination half-life due to slow dissociation from the ACE binding site, which supports consistent 24-hour blood pressure control with once-daily dosing. Peak plasma concentrations of perindopril occur about 1 hour after oral administration, while perindoprilat peaks later.

Storage and Handling

Store Aceon tablets at controlled room temperature, 20°C to 25°C (68°F to 77°F). Protect from moisture. Keep the container tightly closed and dispense in a tight, light-resistant container as defined in the USP. Keep all medications out of the reach of children and pets.

Reporting Side Effects

If you experience a side effect, especially a serious one, report it to your doctor. Patients and healthcare professionals can also report adverse events to the FDA’s MedWatch program at FDA MedWatch or by phone at 1-800-FDA-1088. Reporting helps the FDA monitor the safety of medications.

References

References and Medical Sources

The information on this page is derived from the official prescribing information and authoritative clinical resources.

  1. U.S. Food and Drug Administration (FDA). Aceon (perindopril erbumine) tablets prescribing information. Revised September 2017. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/020184s023lbl.pdf
  2. MedlinePlus. Perindopril. U.S. National Library of Medicine. Updated July 20, 2024. Available at: https://medlineplus.gov/druginfo/meds/a602017.html
  3. Fox KM; EURopean trial On reduction of cardiac events with Perindopril in stable coronary Artery disease Investigators. Efficacy of perindopril in reduction of cardiovascular events among patients with stable coronary artery disease: randomised, double-blind, placebo-controlled, multicentre trial (the EUROPA study). Lancet. 2003;362(9386):782-788. DOI: 10.1016/S0140-6736(03)14286-9
  4. Vrints C, et al. 2024 ESC Guidelines for the management of chronic coronary syndromes. Eur Heart J. 2024;45(36):3415-3537. DOI: 10.1093/eurheartj/ehae177
Disclaimer

Disclaimer: The information on this site is provided for informational purposes only and is not medical advice. It does not replace professional medical consultation, diagnosis, or treatment. Do not self-medicate based on the information presented on this site. Always consult with a doctor or other qualified healthcare professional before making any decisions about your health.

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