Drug Interactions of Antihypertensives (Part 3):

Drug Interactions of Direct Renin Inhibitor (Aliskiren):

More presentations from Naina Mohamed Pakkir Maideen

©   Aliskiren is a Direct Renin Inhibitor (DRI) and is useful in the treatment of Hypertension.

©   Aliskiren inhibits Renin which is essential for the conversion of Angiotensinogen to Angiotensin I. Hence the formation of Angiotensin II is limited.  Angiotensin II can increase the blood pressure by vasoconstriction and by stimulating the production of aldosterone from the adrenal cortex, which increases the reabsorption of sodium.

©   Aliskiren can interact significantly with many drugs including ACE Inhibitors (ACEIs), Angiotensin Receptor Blockers (ARBs), Cyclosporine, Itraconazole, P-gp Inhbitors and Potassium sparing diuretics.

©   It is contraindicated to use Aliskiren with ACEIs (Captopril, Lisinopril, Perindopril, etc.) or ARBs (Losartan, Candesartan, Valsartan, etc.) in diabetes patients, due to increased risk of Hyperkalemia, Renal impairment and Hypotension.

©   The blood concentrations of Aliskiren might be elevated by the drugs such as Cyclosporine, Itraconazole and P-gp Inhbitors (Simeprevir, Lomitapide, Ulipristal, Nilotinib, Eliglustat, Tocofersolan, etc.).

©   Severe arrhythmias may occur in patients taking Aliskiren and Potassium Sparing Diuretics (Spiranolactone, Amiloride, Triamterene, etc.), due to increased risk of Hyperkalemia.

Pregnancy:

©   Aliskiren should be discontinued as soon as possible, if pregnancy occurs during use.

Breast Feeding:

©   It is recommended to discontinue either Aliskiren or breast feeding.