Aceon (perindopril erbumine) is an ACE inhibitor used to treat high blood pressure and reduce the risk of heart events in people with stable coronary artery disease. It works by relaxing blood vessels, which lowers blood pressure and makes it easier for the heart to pump. But Aceon isn’t the only option. Many patients and doctors look at alternatives based on cost, side effects, effectiveness, and individual health needs.
How Aceon Works and Who Takes It
Aceon contains perindopril erbumine, a prodrug that turns into perindopril in the body. Perindopril blocks the angiotensin-converting enzyme (ACE), which stops the body from making angiotensin II - a chemical that narrows blood vessels. Less angiotensin II means wider vessels, lower pressure, and less strain on the heart.
The usual starting dose is 4 mg once daily, often increased to 8 mg if needed. It’s commonly prescribed for adults with hypertension, especially those with heart disease. People with diabetes and kidney issues may also benefit, since ACE inhibitors help protect kidney function.
But Aceon isn’t for everyone. It can cause a dry cough, dizziness, or high potassium levels. In rare cases, it triggers angioedema - swelling of the face, lips, or throat - which requires emergency care. If you’ve had reactions to other ACE inhibitors, you shouldn’t take Aceon.
Top Alternatives to Aceon
There are several well-studied alternatives, grouped by drug class. The most common are other ACE inhibitors, ARBs, calcium channel blockers, and thiazide diuretics. Each has pros and cons.
1. Lisinopril (Prinivil, Zestril)
Lisinopril is the most widely prescribed ACE inhibitor in the U.S. and U.K. It’s similar to Aceon in how it works but has a longer track record and is available as a generic, making it much cheaper - often under £5 for a 30-day supply.
Studies show lisinopril lowers blood pressure just as well as perindopril in most patients. The main difference? Lisinopril is taken once daily, like Aceon, but it has a slightly higher rate of dry cough - about 10-20% of users report it. If you’re on Aceon because you tolerate it well, switching isn’t necessary. But if cost is an issue, lisinopril is a solid, evidence-backed alternative.
2. Ramipril (Altace)
Ramipril has strong data supporting its use in patients with heart disease, especially after a heart attack. The HOPE study showed ramipril reduced heart attacks, strokes, and death in high-risk patients - even more than some other ACE inhibitors.
Like Aceon, ramipril is taken once daily. It’s also available generically and costs about the same as lisinopril. Some doctors prefer ramipril for patients with diabetes or chronic kidney disease because of its proven kidney-protective effects. If you’re on Aceon for heart disease protection, ramipril might be a better fit.
3. Losartan (Cozaar)
Losartan is an ARB - angiotensin II receptor blocker. It works like ACE inhibitors but blocks angiotensin II directly, instead of stopping its production. This means fewer side effects like dry cough - only about 2-3% of users experience it.
Studies show losartan is just as effective as perindopril for lowering blood pressure. It’s also the go-to alternative for people who can’t tolerate ACE inhibitors due to cough or swelling. Losartan is available as a generic, and in the U.K., it’s often cheaper than Aceon.
One downside: losartan can cause dizziness more often than ACE inhibitors, especially at first. It’s also not as strongly linked to reducing heart attacks in non-diabetic patients compared to ramipril or perindopril. But for many, it’s the best-tolerated option.
4. Amlodipine (Norvasc)
Amlodipine is a calcium channel blocker, not an ACE inhibitor. It works by relaxing the muscles in artery walls, which opens them up and lowers pressure. It’s often combined with ACE inhibitors when one drug isn’t enough.
Compared to Aceon, amlodipine has fewer side effects like cough or high potassium. But it can cause swollen ankles, flushing, or headaches. It’s especially useful for older adults or Black patients, who tend to respond better to calcium channel blockers than ACE inhibitors.
Guidelines from NICE (National Institute for Health and Care Excellence) recommend amlodipine as a first-line option for people over 55 or of African/Caribbean descent. If you’re on Aceon and still have high blood pressure, adding amlodipine might work better than switching.
5. Hydrochlorothiazide (HCTZ)
Hydrochlorothiazide is a thiazide diuretic. It helps the kidneys remove extra salt and water, which reduces blood volume and pressure. It’s one of the oldest and cheapest blood pressure meds - often under £2 a month.
While not as powerful as ACE inhibitors at reducing heart events, HCTZ is very effective for mild to moderate hypertension. It’s often used in combination pills, like with lisinopril or amlodipine. Side effects include low potassium, dehydration, and increased urination.
For younger, otherwise healthy patients with mild high blood pressure, HCTZ might be a better starting point than Aceon - especially if cost or side effects are concerns.
Comparison Table: Aceon vs. Common Alternatives
| Medication | Class | Daily Dose | Generic Cost (U.K.) | Common Side Effects | Best For |
|---|---|---|---|---|---|
| Aceon (perindopril erbumine) | ACE inhibitor | 4-8 mg | £15-£25 | Dry cough, dizziness, high potassium | Heart disease, kidney protection |
| Lisinopril | ACE inhibitor | 5-40 mg | £3-£8 | Dry cough (more common), dizziness | General hypertension, cost-sensitive patients |
| Ramipril | ACE inhibitor | 2.5-10 mg | £5-£12 | Dry cough, fatigue | Post-heart attack, diabetes, kidney disease |
| Losartan | ARB | 25-100 mg | £4-£10 | Dizziness, back pain, high potassium | ACE inhibitor intolerance, cough |
| Amlodipine | Calcium channel blocker | 5-10 mg | £4-£9 | Swollen ankles, flushing, headache | Older adults, Black patients, combination therapy |
| Hydrochlorothiazide | Thiazide diuretic | 12.5-50 mg | £1-£3 | Low potassium, frequent urination, dehydration | Mild hypertension, first-line for younger patients |
When to Switch from Aceon
You shouldn’t switch medications just because you heard about another drug. But here are clear reasons to consider a change:
- You have a persistent dry cough that doesn’t go away - switch to an ARB like losartan.
- Your blood pressure isn’t controlled on 8 mg of Aceon - adding amlodipine or HCTZ might work better than increasing the dose.
- You’re paying over £20 a month for Aceon - generic lisinopril or losartan could save you 70% or more.
- You have diabetes or kidney disease - ramipril has more proven benefits than perindopril in these cases.
- You’re over 55 or of African/Caribbean descent - guidelines suggest calcium channel blockers as first-line, not ACE inhibitors.
Never stop Aceon suddenly. Stopping abruptly can cause rebound high blood pressure or even heart problems. Always talk to your doctor or pharmacist before switching.
What Your Doctor Will Consider
Doctors don’t pick blood pressure meds based on brand names or price alone. They look at your whole health picture:
- Age: Under 55? ACE inhibitors or ARBs are often first. Over 55? Calcium channel blockers or diuretics.
- Ethnicity: People of African or Caribbean descent respond better to calcium channel blockers and diuretics than ACE inhibitors.
- Other conditions: Diabetes? Kidney disease? Heart failure? ACE inhibitors or ARBs are preferred.
- Cost: If you’re paying out of pocket, generics like lisinopril or HCTZ are often the smartest choice.
- Side effects: If you had a bad reaction to one ACE inhibitor, you’re likely to react to others - switch to an ARB.
For example, a 68-year-old man with high blood pressure and no other conditions might do better on amlodipine than Aceon. A 52-year-old woman with diabetes and early kidney damage might be better on ramipril. There’s no one-size-fits-all.
What Not to Do
Don’t try to self-switch based on online reviews. Some people report feeling better on losartan after switching from Aceon - but that doesn’t mean it’s right for you. Others stop their meds because they’re “too expensive” and end up in the hospital.
Also, avoid buying blood pressure meds from unregulated online pharmacies. Fake or contaminated versions of Aceon or lisinopril have been found in the U.K. market. Always get prescriptions filled through a licensed pharmacy.
Bottom Line: Is There a Better Option Than Aceon?
Aceon works well for many people, especially those with heart disease or kidney issues. But it’s not the cheapest, and it’s not always the best-tolerated. For most patients, generic lisinopril or losartan offer the same benefits at a fraction of the cost.
If you’re on Aceon and doing fine - no cough, no dizziness, your pressure is under control - there’s no need to switch. But if you’re struggling with side effects, cost, or your numbers aren’t where they should be, talk to your doctor about alternatives. There’s a good chance you can find a safer, cheaper, or more effective option.
Is Aceon the same as perindopril?
Yes. Aceon is the brand name for perindopril erbumine. Perindopril is the active ingredient; erbumine is a salt form that helps the body absorb it. Generic versions are labeled simply as perindopril.
Can I take losartan instead of Aceon?
Yes, if you can’t tolerate Aceon due to a dry cough or swelling. Losartan is an ARB and works similarly but doesn’t cause cough in most people. It’s also cheaper and just as effective for lowering blood pressure. But if you have heart disease, ramipril may be more effective than losartan for preventing events.
Why is Aceon more expensive than other ACE inhibitors?
Aceon is a brand-name drug with no generic version available in the U.K. yet. Other ACE inhibitors like lisinopril and ramipril have been generic for years, so their prices are much lower. The cost difference isn’t about effectiveness - it’s about patents and market competition.
Do ACE inhibitors damage the kidneys?
No - they protect them. ACE inhibitors like Aceon, lisinopril, and ramipril are often used to slow kidney damage in people with diabetes or high blood pressure. They reduce protein in the urine and lower pressure inside the kidneys. But they can raise potassium levels, so kidney function is monitored regularly.
What’s the safest blood pressure medicine?
There’s no single “safest” drug. For most people, generic lisinopril or amlodipine are considered very safe and effective. ARBs like losartan are safer if you get cough from ACE inhibitors. Diuretics like HCTZ are safe for younger patients but require monitoring for potassium. Safety depends on your health profile, not the drug alone.
Next Steps
If you’re on Aceon and wondering if you should switch, start by checking your blood pressure logs. Are your numbers stable? Are you experiencing side effects? Then talk to your GP or pharmacist. Ask: “Is there a generic alternative that works just as well?” or “Could a different class of drug be better for me?”
Bring a list of all your medications. Many people don’t realize they’re taking a combination pill - like lisinopril with HCTZ - and think they’re only on one drug. Your doctor can help you simplify your regimen, cut costs, and improve results.
Don’t wait until your next routine appointment. If you’re having side effects or can’t afford your meds, call your doctor now. There’s almost always a better option - you just need to ask for it.
