Which medications in the drug class Renin Inhibitors/Combos are used in the treatment of Hypertension?

Updated: Feb 22, 2019
  • Author: Matthew R Alexander, MD, PhD; Chief Editor: Eric H Yang, MD  more...
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Answer

Renin Inhibitors/Combos

Renin inhibitors act within the renin-angiotensin system (RAS), a hormone system important in the regulation of blood pressure, electrolyte homeostasis, and vascular growth. Renin inhibitors have an additive effect when used with diuretics. Avoid the use of these agents in pregnancy.

Aliskiren (Tekturna)

Aliskiren decreases plasma renin activity and inhibits conversion of angiotensinogen to angiotensin I (as a result, also decreasing angiotensin II) and thereby disrupts the renin-angiotensin-aldosterone system feedback loop. It is indicated for hypertension as monotherapy or in combination with other antihypertensive drugs. This agent remains under investigation.

Keep in mind that aliskiren can cause adverse events when used in combination with ACE-inhibitor or angiotensin-receptor-blocker (ARB) therapy. In patients who have hypertension and type 2 diabetes and renal impairment and are at high risk of cardiovascular and renal events, there is an increased risk of nonfatal stroke, renal complications, hypokalemia, and hypotension when aliskiren is added to ACE inhibitor or ARB therapy. See the Novartis December 2011 press release, "Novartis announces termination of ALTITUDE study with Rasilez®/ Tekturna® in high-risk patients with diabetes and renal impairment."


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