Aliskiren
Contraindicated
Textbook
Increased risk of hypotension, hyperkalemia, and renal impairment.
Avoid concomitant use.
Source: G&G 14e · p603
Drug reference
Azilsartan
ARB · Antihypertensive
Also known as Azilsartan medoxomil
ARBAntihypertensive
CDSCO approvedSchedule H
EXCRETION
—
not curated
INTERACTIONS
12 major
incl. contraindicated
PREGNANCY
Contraindicated during the second and third trimesters of pregnancy due to risk of fetal hypotension, anuria, renal failure, malformations or death. Increased teratogenic risk in first trimester.
FDA category + note
Top interactionssee all 12 →
- AliskirenContraindicatedTextbookG&G 14e · p603
- Sacubitril ValsartanContraindicatedTextbookG&G 14e · p602
- Angiotensin Converting Enzyme InhibitorsSevereTextbookHarrison 22e · p2396
- BenazeprilSevereTextbookG&G 14e
Mechanism
Azilsartan is an angiotensin II type 1 (AT1) receptor blocker, inhibiting the effects of angiotensin II. Unlike ACE inhibitors, it does not inhibit the breakdown of bradykinin and other kinins, offering more selective and potentially more complete inhibition of angiotensin action.
Indications
HypertensionHeart failureDiabetic nephropathy
Dosing
- Adult
- after any change in dose or during intercurrent illness. Other drugs used for Hypertension Amiloride hydrochloride, p. 243 . Chlortalidone, p. 244 . Cotriamterzide, p. 245 . Metolazone, p. Torasemide, p. 242 . Triamterene with chlortalidone, p. Xipamide, p. 245 ANTIHYPERTENSIVES, CENTRALLY ACTING Clonidine hydrochloride ▶ ▶ BY MOUTH ▶ Adult: Initially 50 micrograms twice daily for 2 we...
Pharmacokinetics
Peak effect
plasma concentrations (Cmax) are achieved within 1.5 to 3 h
Half-life
elimination t1/2 is approximately 11 h
Bioavailability
approximately 60% and is not affected by food
Metabolism
prodrug is hydrolyzed in the GI tract into the active form, azilsartan...metabolized mostly by CYP2C9 into inactive metabolites
Excretion
Elimination of the drug is 55% in feces and 42% in urine. About 15% of the dose is eliminated unchanged in urine.
Contraindications
- Second and third trimesters of pregnancy
- First trimester of pregnancy (increased teratogenic risk)
- Concomitant use with ACE inhibitors
- Concomitant use with aliskiren
- Do not use in combination with ACE inhibitor
- Contraindicated in pregnancy
Side effects
Common
HyperkalemiaAltered sense of tasteAllergic skin rashesDrug feverCoughhypotensionHyperkalemia in CKDReduced GFRAcute kidney failure in severe bilateral renal artery stenosis
Serious
- Acute renal failure
- Angioedema
- anaphylaxis
- abnormal hepatic function
- hepatitis
- neutropenia
- leukopenia
- agranulocytosis
- pruritus
- urticaria
- hyponatremia
- alopecia
- vasculitis
Pregnancy & lactation
Pregnancy
Contraindicated during the second and third trimesters of pregnancy due to risk of fetal hypotension, anuria, renal failure, malformations or death. Increased teratogenic risk in first trimester.
Drug interactions
Sacubitril Valsartan
Contraindicated
Textbook
Potentially excessive hypotension, increased risk of adverse effects.
Do not use in conjunction with other ARBs.
Source: G&G 14e · p602
Angiotensin Converting Enzyme Inhibitors
Severe
Textbook
Greater incidence of acute kidney injury (AKI) and adverse cardiac events.
The combination of these two classes should be avoided.
Source: Harrison 22e · p2396
Benazepril
Severe
Textbook
Increased worsening of renal function, hypotension, syncope, and hyperkalemia without increased efficacy.
Not recommended for the treatment of hypertension. Previous studies indicate more harm than benefit.
Source: G&G 14e
Captopril
Severe
Textbook
Increased worsening of renal function, hypotension, syncope, and hyperkalemia without increased efficacy.
Not recommended for the treatment of hypertension. Previous studies indicate more harm than benefit.
Source: G&G 14e
Enalapril
Severe
Textbook
Increased worsening of renal function, hypotension, syncope, and hyperkalemia without increased efficacy.
Not recommended for the treatment of hypertension. Previous studies indicate more harm than benefit.
Source: G&G 14e
Enalaprilat
Severe
Textbook
Increased worsening of renal function, hypotension, syncope, and hyperkalemia without increased efficacy.
Not recommended for the treatment of hypertension. Previous studies indicate more harm than benefit.
Source: G&G 14e
Fosinopril
Severe
Textbook
Increased worsening of renal function, hypotension, syncope, and hyperkalemia without increased efficacy.
Not recommended for the treatment of hypertension. Previous studies indicate more harm than benefit.
Source: G&G 14e
Imidapril
Severe
Textbook
Greater incidence of acute kidney injury (AKI) and adverse cardiac events.
The combination of these two classes should be avoided.
Source: Harrison 22e · p2396
Lisinopril
Severe
Textbook
Increased worsening of renal function, hypotension, syncope, and hyperkalemia without increased efficacy.
Not recommended for the treatment of hypertension. Previous studies indicate more harm than benefit.
Source: G&G 14e
Moexipril
Severe
Textbook
Increased worsening of renal function, hypotension, syncope, and hyperkalemia without increased efficacy.
Not recommended for the treatment of hypertension. Previous studies indicate more harm than benefit.
Source: G&G 14e
Perindopril
Severe
Textbook
Increased worsening of renal function, hypotension, syncope, and hyperkalemia without increased efficacy.
Not recommended for the treatment of hypertension. Previous studies indicate more harm than benefit.
Source: G&G 14e
Related guidelines
Other ARB drugs
Ask House about Azilsartan
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Sources: Goodman & Gilman 14e, Harrison 22e, BNF·Verified: 2026-05-13 · House clinical team