Azilsartan
Contraindicated
Textbook
Increased risk of hypotension, hyperkalemia, and renal impairment.
Avoid concomitant use.
Source: G&G 14e · p603
Drug reference
Aliskiren
Antihypertensive
Antihypertensive
CDSCO approvedSchedule H
EXCRETION
—
not curated
INTERACTIONS
12 major
incl. contraindicated
PREGNANCY
X
FDA category + note
Top interactionssee all 12 →
- AzilsartanContraindicatedTextbookG&G 14e · p603
- Losartan + HydrochlorothiazideContraindicatedTextbookG&G 14e · p603
- Olmesartan + AmlodipineContraindicatedTextbookG&G 14e · p603
- Olmesartan + HydrochlorothiazideContraindicatedTextbookG&G 14e · p603
Mechanism
Aliskiren is a direct renin inhibitor that blocks the rate-limiting step in angiotensin II (AngII) production. It is licensed for the treatment of hypertension.
Indications
HypertensionCongestive heart failure (CHF)Renoprotection in hypertensionRenoprotection in diabetes mellitus
Dosing
- Renal adjustment
- Contraindicated in combination with an ACE inhibitor for patients with eGFR less than 60 mL/minute/1.73 m2
Pharmacokinetics
Peak effect
3 to 6 h
Duration
BP lowering effect persists for days after regular intake
Half-life
20 to 45 h
Bioavailability
low (~2.5%)
Protein binding
50%
Metabolism
Hepatic metabolism is minimal.
Excretion
Elimination is mostly as unchanged drug in feces; approximately 25% of the absorbed dose appears in the urine as the parent drug.
Contraindications
- Concomitant use with an ACE inhibitor in patients with an eGFR less than 60 mL/minute/1.73 m2
- Concomitant use with an ACE inhibitor in patients with diabetes mellitus
- Concomitant use with an angiotensin-II receptor antagonist (due to increased risk of hyperkalaemia, hypotension, and renal impairment compared to single drug use)
- Pregnancy
- Combination with other RAS inhibitors
Side effects
Common
diarrheaabdominal paindyspepsiagastroesophageal refluxheadachedizzinessfatigueupper respiratory tract infectionback painangioedemacoughrashhypotensionelevated uric acidrenal stonesgoutDiarrhea (especially at higher doses)Loose motions
Serious
- hyperkalemia in diabetics on combination therapy
- Angioedema
- Increased cardiovascular events (in combination with ARB/ACE inhibitor)
- Renal worsening (in combination with ARB/ACE inhibitor)
- Hypotension (in combination with ARB/ACE inhibitor)
- Hyperkalemia (in combination with ARB/ACE inhibitor)
- Acute hypotension (much less frequent than ACEIs)
- Hyperkalaemia (much less frequent than ACEIs)
- Cough (much less frequent than ACEIs)
- Angioedema (much less frequent than ACEIs)
- Rashes (much less frequent than ACEIs)
Pregnancy & lactation
Pregnancy
X
Drug interactions
Losartan + Hydrochlorothiazide
Contraindicated
Textbook
Increased risk of hypotension, hyperkalemia, and renal impairment.
Avoid concomitant use.
Source: G&G 14e · p603
Olmesartan + Amlodipine
Contraindicated
Textbook
Increased risk of hypotension, hyperkalemia, and renal impairment.
Avoid concomitant use.
Source: G&G 14e · p603
Olmesartan + Hydrochlorothiazide
Contraindicated
Textbook
Increased risk of hypotension, hyperkalemia, and renal impairment.
Avoid concomitant use.
Source: G&G 14e · p603
Sacubitril With Valsartan
Contraindicated
Textbook
Increased risk of hypotension, hyperkalemia, and renal impairment.
Avoid concomitant use.
Source: G&G 14e · p603
Telmisartan + Amlodipine
Contraindicated
Textbook
Increased risk of hypotension, hyperkalemia, and renal impairment.
Avoid concomitant use.
Source: G&G 14e · p603
Telmisartan + Amlodipine + Hydrochlorothiazide
Contraindicated
Textbook
Increased risk of hypotension, hyperkalemia, and renal impairment.
Avoid concomitant use.
Source: G&G 14e · p603
Telmisartan + Chlorthalidone
Contraindicated
Textbook
Increased risk of hypotension, hyperkalemia, and renal impairment.
Avoid concomitant use.
Source: G&G 14e · p603
Telmisartan + Hydrochlorothiazide
Contraindicated
Textbook
Increased risk of hypotension, hyperkalemia, and renal impairment.
Avoid concomitant use.
Source: G&G 14e · p603
Benazepril
Contraindicated
Database
Dual RAAS blockade
Avoid combination
Source: Kimi deep-research + Cla
Candesartan
Contraindicated
Database
Dual RAAS blockade → hyperkalaemia/AKI/hypotension
Do not combine in diabetes/eGFR <60
Source: Kimi deep-research + Cla · p603
Irbesartan
Contraindicated
Database
Dual RAAS blockade → hyperkalaemia/AKI/hypotension
Do not combine in diabetes or eGFR <60
Source: Kimi deep-research + Cla
Related guidelines
Other Antihypertensive drugs
Ask House about Aliskiren
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: KD Tripathi 7e, Goodman & Gilman 14e, Katzung, BNF·Verified: 2026-05-10 · House clinical team