From the Guidelines
Aliskiren (brand name Tekturna) is no longer commonly used for hypertension treatment due to safety concerns and limited benefits compared to other antihypertensives. The 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults recommends against using aliskiren in combination with ACE inhibitors or ARBs, as this combination increases the risk of kidney problems, hypotension, and hyperkalemia 1. The guideline also notes that aliskiren is very long-acting and may cause acute renal failure in patients with severe bilateral renal artery stenosis, and should be avoided in pregnancy.
Some of the key points to consider when evaluating the use of aliskiren for hypertension treatment include:
- The increased risk of hyperkalemia in patients with chronic kidney disease (CKD) or those taking potassium supplements or potassium-sparing diuretics 1
- The potential for acute renal failure in patients with severe bilateral renal artery stenosis 1
- The limited benefits of aliskiren compared to other antihypertensives, such as thiazide diuretics, ACE inhibitors, ARBs, and calcium channel blockers, which have stronger evidence for cardiovascular protection and better safety profiles 1
- The higher cost of aliskiren compared to other antihypertensive medications
Overall, the use of aliskiren for hypertension treatment is not recommended due to its limited benefits and potential safety risks, and other antihypertensive medications are preferred as first-line agents.
From the FDA Drug Label
Aliskiren tablets are a renin inhibitor (RI) indicated for the treatment of hypertension in adults and in pediatric patients weighing 50 kg or greater who are at least 6 years of age, to lower blood pressure. The FDA drug label does not mention "tekTurna" but Aliskiren is still used for the treatment of hypertension in adults and pediatric patients, as indicated in the drug label 2.
- The recommended dosage of aliskiren is either 150 or 300 mg once daily.
- Studies have demonstrated the antihypertensive effects of aliskiren in patients with mild-to-moderate hypertension 2. However, there is no information about "tekTurna" in the provided drug labels.
From the Research
Current Usage of Aliskiren and Tekturna
- Aliskiren, also known as Tekturna, is an orally active, nonpeptidic inhibitor of renin, used in the management of hypertension 3.
- It was approved by the US Food and Drug Administration in 2007 for the treatment of hypertension and may be used alone or in combination with other antihypertensive agents 3, 4.
- However, there is no recent evidence to suggest that Aliskiren or Tekturna is still widely used for hypertension, as the most recent study provided is from 2012 5.
Efficacy and Safety
- Aliskiren has been shown to be effective in reducing blood pressure and is generally well tolerated 3, 6, 7.
- It has been compared to other antihypertensive agents, such as hydrochlorothiazide, ramipril, and valsartan, and has been found to be similar in efficacy 3, 6.
- The most common adverse effects reported in clinical trials were headache, fatigue, dizziness, diarrhea, and nasopharyngitis 6, 7.
Combination Therapy
- Aliskiren has been shown to provide significant additional blood pressure-lowering effects when combined with other antihypertensive agents, such as hydrochlorothiazide, ramipril, and valsartan 3, 6.
- However, the use of Aliskiren in combination with ACE inhibitors or ARBs has been associated with an increased risk of adverse effects, particularly in patients with diabetes and renal impairment 5.