Indications
Aliskiren is used to treat high blood pressure (hypertension) in adults. It can be used alone or with other blood pressure medicines. Lowering blood pressure reduces the risk of stroke, heart attack, heart failure and kidney damage.
How It Works
Aliskiren is a direct renin inhibitor. Renin is an enzyme made by the kidneys that starts a chain of reactions producing angiotensin II, a hormone that narrows blood vessels and makes the body hold on to salt and water. By blocking renin at the very first step, Aliskiren lowers angiotensin II levels, so blood vessels relax and blood pressure falls.
Dosage and Administration
Adults: usually 150 mg once daily, which the doctor may increase to 300 mg once daily if needed. Take it at the same time each day with a light meal, but avoid taking it with a high-fat meal. Swallow whole with water. The full effect is usually seen within about 2 weeks. Keep taking it even if you feel well.
Interactions
- Do not combine with ACE inhibitors (such as Enalapril, Ramipril) or angiotensin receptor blockers (such as Losartan, Valsartan) in people with diabetes or kidney impairment, because of a higher risk of kidney problems, high potassium and low blood pressure.
- Ciclosporin, Itraconazole and Quinidine greatly raise its levels and must not be used with it.
- Potassium supplements, salt substitutes and potassium-sparing diuretics (such as Spironolactone) can raise potassium.
- NSAID painkillers (such as Ibuprofen) can reduce its effect and harm the kidneys.
- Grapefruit juice, Furosemide and some other drugs can change its levels.
Contraindications
- Allergy to Aliskiren
- Pregnancy
- History of angioedema (swelling of the face, lips, tongue or throat)
- Use with Ciclosporin, Itraconazole or Quinidine
- Use with an ACE inhibitor or ARB in people with diabetes or moderate to severe kidney impairment
- Children under 18 years
Side Effects
- Diarrhoea (more common at higher doses)
- Dizziness, especially when standing up
- Raised potassium on blood tests
- Headache, cough, rash
- Rarely, kidney problems or angioedema
Get urgent medical help if you develop swelling of the face, lips, tongue or throat, difficulty breathing or swallowing, fainting, severe diarrhoea with dehydration, a slow or irregular heartbeat, muscle weakness, or a sharp fall in urine output.
Pregnancy and Lactation
Do not use during pregnancy; medicines acting on this hormone system can seriously harm the unborn baby, especially in the second and third trimesters. Stop and contact your doctor as soon as you find out you are pregnant. Avoid during breastfeeding, as safety is not known.
Precautions and Warnings
- Kidney function and potassium should be checked regularly, especially if you have diabetes, kidney disease or heart failure.
- Dehydration from vomiting, diarrhoea or heavy sweating can cause low blood pressure; talk to your doctor.
- Use with care in narrowing of the kidney arteries.
- Rise slowly from sitting or lying to avoid dizziness.
Overdose
Overdose mainly causes low blood pressure, with dizziness or fainting. Lie down with legs raised and seek medical help straight away.
Therapeutic Class
Antihypertensive, direct renin inhibitor
Storage
Store below 30°C in a dry place, in the original pack to protect from moisture, away from light and out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.