Aliskiren Disease Interactions

The use of aliskiren is contraindicated in patients with diabetes who are receiving angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs), as there is an increased risk of renal impairment, hyperkalemia, and hypotension.

Symptomatic hypotension may occur after treatment initiation with aliskiren in patients with marked volume depletion, salt depletion, or with combined use of aliskiren and other agents acting on the renin-angiotensin-aldosterone system. It is recommended to correct the volume or salt depletion before administering aliskiren. Close monitoring is recommended.

Renal function should be monitored periodically in patients treated with aliskiren, as changes can occur including acute renal failure. Patients on aliskiren whose renal function may depend in part of the RAAS (renin-angiotensin-aldosterone system), such as patients with renal artery stenosis, severe heart failure, or postmyocardial infarction may be at higher risk for developing acute renal failure. Treatment should be discontinued in any patients who develop clinically significant decrease in renal function. Patients with renal impairment should be observed closely. The safety and effectiveness of aliskiren have not been established in patients with severe renal impairment (CrCl < 30 mL/min), as these patients were excluded from clinical trials.