Aliskiren and Hydrochlorothiazide

Antihypertensive · Renin inhibitor/Thiazide diuretic

Indications

Hypertension.

Dosage

Adults: 1 tab once daily. Children: Not recommended.

Adverse Effects

Diarrhoea, rash, rarely angioedema, anaemia, hyperkalaemia, arthralgia, dizziness, anorexia, epigastric distress.

Risk Factor (Pregnancy/Lactation)

Pregnancy: Contraindicated in pregnancy. Lactation: Contraindicated or not recommended. Contraindications: Aliskiren: Hereditary or idiopathic angioedema. Severe renal impairment (eGFR <30 mL/min/1.73 m2). Hydrochlorothiazide: Anuria, renal decompensation. Precautions: Patients taking concomitant diuretics, on a low sodium diet, or who are dehydrated (first dose may cause hypotension, initiate with care), renal artery stenosis, renal impairment, monitor plasma-potassium concentration and renal function in renal impairment, hepatic impairment, diabetes mellitus and heart failure. History of angioedema. Advise patients to report any symptoms suggestive of allergic reactions. Gout, diabetes, patients with moderate to high cholesterol concentrations.

Interactions

Angiotensin-II receptor antagonists, anticoagulants, antifungals, diuretics, potassium salts, K+-sparing diuretics, K+ suppl, other antihypertensives, heparin, digoxin, furosemide, torasemide, macrolides, amiodarone, St John's wort, rifampicin, cyclosporin, NSAIDs, fruit juice, drinks containing plant extracts, ACE inhibitors, neuromuscular blocking agents, oral hypoglycaemia, beta blockers.

Pharmacokinetics

ALISKIREN: Onset of action: Max antihypertensive effect: Within 2 wks. Absorption: Poor, absorption reduced by high-fat meal. Metabolism: In vitro studies indicate hepatic metabolism. Bioavailability: Approx. 3%. Half-life elimination: Approx. 24 hrs. Time to peak, plasma: 1-3 hrs. Excretion: Urine, faeces. HYDROCHLOROTHIAZIDE: Onset of action: Diuresis: Infants: 2-6 hrs. Adults: Approx. 2 hrs. Peak effect: 4-6 hrs. Duration: Infants: 8 hrs. Adults: 6-12 hrs. Absorption: Well absorbed, absorption is decreased in patients with CHF. Metabolism: Not metabolized. Bioavailability: 65%-75%. Half-life elimination: Approx. 6-15 hrs. Time to peak: Approx. 1-5 hrs. Excretion: Urine.

Compiled by Healify Pharmacy from published drug references. How we compile it →

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