Formulary
Aliskiren: Indications, Dosing, Side Effects and Interactions
Renin inhibitors inhibit renin directly; renin converts angiotensinogen to angiotensin .
MedNext Academy | 3 min read
Aliskiren: Indications, Dosing, Side Effects and Interactions
Renin inhibitors inhibit renin directly; renin converts angiotensinogen to angiotensin .
Drug action
Renin inhibitors inhibit renin directly; renin converts angiotensinogen to angiotensin .
Indications and dose
**Essential hypertension either alone or in combination with other antihypertensives**
- **Adult** (By Mouth): 150 mg once daily, increased if necessary to 300 mg once daily.
Cautions
Combination treatment with an ACE inhibitor; combination treatment with an angiotensin-II receptor antagonist; concomitant use of diuretics (first doses may cause hypotension-initiate with care); history of angioedema; moderate to severe congestive heart failure; patients at risk of renal impairment; salt depletion (first doses may cause hypotension-initiate with care); volume depletion (first doses may cause hypotension-initiate with care)
Contraindications
Concomitant treatment with an ACE inhibitor or an angiotensin-II receptor antagonist in patients with an eGFR less than 60 mL/minute/1.73 m 2 ; concomitant treatment with an ACE inhibitor or an angiotensin-II receptor antagonist in patients with diabetes mellitus; hereditary angioedema; idiopathic angioedema
Side effects
Common or very common Arthralgia; diarrhoea; dizziness; electrolyte imbalance Uncommon Cough; oral disorder; palpitations; peripheral oedema; renal impairment; severe cutaneous adverse reactions (SCARs); skin reactions Rare or very rare Angioedema; hypersensitivity Frequency not known Dyspnoea; hepatic disorders; nausea; vertigo; vomiting Side-effects, further information If diarrhoea is severe or persistent discontinue treatment.
Interactions
**Other interactions (21):**
- Clinical trial data has shown that dual blockade of the renin-angiotensin-aldosterone-system (RAAS) through the combined use of ACE-inhibitors, angiotensin II receptor blockers or aliskiren is...
- Some drugs or therapeutic classes may increase the occurrence of hyperkalaemia: aliskiren, potassium salts, potassium-sparing diuretics (e.g.
- Concomitant use contra-indicated (see section 4.3): Aliskiren: In diabetic or impaired renal patients, risk of hyperkalaemia, worsening of renal function and cardiovascular morbidity and mortality...
- Concomitant use not recommended (see section 4.4): Aliskiren: In patients other than diabetic or impaired renal patients, risk of hyperkalaemia, worsening of renal function and cardiovascular...
- Aliskiren reduces the plasma concentration of furosemide given orally.
- Reduced effect of furosemide might be observed in patients treated with both aliskiren and oral furosemide, and it is recommended to monitor for reduced diuretic effect and adjust the dose...
Pregnancy
Manufacturer advises avoid-no information available; other drugs acting on the renin-angiotensin system have been associated with fetal malformations and neonatal death.
Breast feeding
Present in milk in animal studies-manufacturer advises avoid.
Renal impairment
Avoid if eGFR is less than 30 mL/minute/1.73 m 2 -no information available. M See Prescribing in renal impairment . Use with caution in renal artery stenosis-no information available. M
Medicinal forms
Medicinal forms No licensed medicines listed.
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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