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WHAT THE PATIENT NEEDS TO KNOW
Aliskiren is a recently-approved, first-in-class
Adverse effects associated with aliskiren are for the
antihypertensive agent. It is approved for the
most part mild. Excessive reductions in blood
treatment of hypertension as monotherapy or in
pressure have occasionally been reported, as has
combination with other antihypertensive agents.
angioedema. Diarrhea is reported in approximately 2.3% of patients who take aliskiren.
WHAT YOU SHOULD KNOW
Aliskiren is a direct renin inhibitor. Renin is a
substance that is secreted by the kidney in response
Aliskiren is the first drug in its class.
to decreased blood flow in the kidney. Renin secretion is the first step in a sequence that results in the
COMPARISON TO OTHER TREATMENTS
generation of angiotensin I, followed by angiotensin II,
There are no clinical trials comparing aliskiren to other
a substance that causes blood vessel constriction,
treatments for hypertension. Most clinical trials
sodium retention and aldosterone secretion. Other
evaluate aliskiren in combination with existing
antihypertensives have been developed that work on
therapies. For this reason, aliskiren is likely to be used
other steps in this sequence; aliskiren is the first direct
as add-on therapy, at least initially. A 2004 article in
renin inhibitor to be marketed. Aliskiren is initiated at
the Journal of the American Society of Nephrology
150 mg once daily; the dose may be increased to 300
suggests that aliskiren may have synergistic effects
mg in patients who do not have an adequate response
with valsartan, so combinations of aliskiren with
angiotensin receptor blockers may be advantageous; no other combination appears to be distinctively
WHAT YOU MAY NOT KNOW
advantageous. Aliskiren costs at least 35% more than
High-fat meals reduce the absorption of aliskiren;
other commonly used antihypertensive therapies.
patients should take the drug consistently with regard
Therefore, patients with prescription insurance will
to meals. Aliskiren should be discontinued in patients
likely be required to try and fail several other
who may be pregnant due to the risk of fetal harm.
medications before coverage for aliskiren will be
Concomitant use of atorvastatin increases overall
exposure to aliskiren by 50%.
does not reflect insurance co-payments as these vary with
only and are not intended to be thought of as dose equivalents.
Prescribing information: http://www.pharma.us.novartis.com/product/pi/pdf/tekturna.pdf Journal of the American Society of Nephrology article suggesting synergy with valsartan:
Explanation of the renin-angiotensin system and its effect on blood pressure:
This publication is intended to provide key practical information regarding this drug product in a brief format. It does
not contain sufficient information upon which to base formulary or other medication use policy decisions.
The information provided was developed by the Center for Drug Policy at the
University of Wisconsin Hospitals and Clinics and published by the Pharmacy Society of Wisconsin.
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