What is Aceon (Perindopril)?
Aceon (perindopril erbumine) is an angiotensin-converting enzyme (ACE) inhibitor that works by inhibiting the conversion of angiotensin I to angiotensin II, resulting in vasodilation and reduced blood pressure. 1
Mechanism of Action
Perindopril is a prodrug that is hydrolyzed after absorption to its active metabolite, perindoprilat. This active form:
- Inhibits ACE, reducing the conversion of angiotensin I to the vasoconstrictor angiotensin II
- Decreases aldosterone secretion, leading to diuresis and natriuresis
- May increase bradykinin levels (a vasodilator)
- Provides 24-hour ACE inhibition of about 60% after standard dosing 1
Clinical Uses
Aceon is primarily used for:
- Treatment of hypertension (high blood pressure)
- Reduction of cardiovascular events in patients with:
Dosage Forms and Administration
- Available in tablet form in strengths of 2 mg, 4 mg, and 8 mg
- Typical dosing range is 4-8 mg once daily for hypertension 1, 3
- Treatment should be initiated at low doses and gradually increased
- Dosage adjustment is required in elderly patients and those with renal impairment 4
Pharmacokinetics
- Rapidly absorbed with peak plasma concentrations occurring at approximately 1 hour
- Oral bioavailability of about 75%
- 30-50% of absorbed perindopril is converted to active perindoprilat
- Peak effects occur 4-6 hours after dosing
- Substantial antihypertensive effect persists for 24 hours, allowing once-daily dosing 1, 4
Clinical Evidence
Perindopril has demonstrated efficacy in several major clinical trials:
- EUROPA trial: Showed significant reduction in cardiovascular events in patients with stable coronary artery disease using 8 mg daily 2
- PROGRESS trial: Combined with indapamide, reduced recurrent stroke risk in patients with history of stroke or TIA 2
- ADVANCE trial: Combined with indapamide, showed benefits in patients with type 2 diabetes 2
Safety Profile and Side Effects
Common side effects include:
- Cough (most common ACE inhibitor-related side effect)
- Dizziness
- Headache
- Fatigue
Important precautions:
- Contraindicated in patients with history of angioedema related to previous ACE inhibitor therapy
- Requires monitoring of renal function and potassium levels
- Use with caution in patients with renal artery stenosis 5
Advantages Compared to Other ACE Inhibitors
- Long duration of action allowing once-daily dosing
- High tissue ACE affinity
- Generally well-tolerated with fewer reports of first-dose hypotension and hyperkalemia compared to some other ACE inhibitors 5, 6
Aceon represents an effective option among ACE inhibitors with established cardiovascular benefits beyond blood pressure reduction, particularly in patients with coronary artery disease, stroke history, or diabetes with cardiovascular risk factors.