Aliskiren Hemifumarate + Hydrochlorothiazide

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Generic Name of Aliskiren Hemifumarate + Hydrochlorothiazide - Learn More

Aliskiren Hemifumarate + Hydrochlorothiazide

Aliskiren Hemifumarate + Hydrochlorothiazide Precaution - What You Need to Know

Before using Aliskiren Hemifumarate and Hydrochlorothiazide, it is critical for patients to consult their healthcare provider to ensure the medication is appropriate for their specific condition and to receive the correct dosage. Important precautions include:
- Renal Impairment: Both Aliskiren and Hydrochlorothiazide can affect kidney function. Patients with renal impairment should be closely monitored for any changes in kidney function, as both drugs may worsen renal function. Aliskiren should be avoided in patients with severe renal impairment (eGFR < 30 mL/min/1.73m²), and dose adjustments may be needed for patients with mild to moderate renal dysfunction.
- Electrolyte Imbalance: Hydrochlorothiazide can lead to electrolyte imbalances such as low potassium (hypokalemia), sodium (hyponatremia), and magnesium (hypomagnesemia), while Aliskiren can increase the risk of hyperkalemia in some patients. Regular monitoring of serum electrolytes is necessary.
- Hypotension: As both drugs lower blood pressure, there is a risk of hypotension, especially after the first dose. Patients should be advised to monitor for symptoms of low blood pressure, such as dizziness, lightheadedness, or fainting, particularly when standing up quickly.
- Pregnancy: Aliskiren is contraindicated during pregnancy, especially during the second and third trimesters, due to the risk of fetal harm. Hydrochlorothiazide should also be used cautiously during pregnancy, as it may reduce plasma volume and fetal blood supply. Both drugs are not recommended during pregnancy, and alternative medications should be considered.
- Liver Disease: Both drugs should be used cautiously in patients with liver disease or impaired liver function, as Hydrochlorothiazide can exacerbate liver dysfunction and Aliskiren requires hepatic metabolism.
- Allergy/Angioedema: Patients with a history of angioedema associated with ACE inhibitors or ARBs should be cautious, as Aliskiren is also a renin inhibitor and may have similar side effects, including the risk of angioedema.

Aliskiren Hemifumarate + Hydrochlorothiazide Indication - Uses and Benefits

The combination of Aliskiren Hemifumarate (a direct renin inhibitor) and Hydrochlorothiazide (a thiazide diuretic) is indicated for the treatment of hypertension (high blood pressure). This combination helps reduce blood pressure through two distinct mechanisms:
- Aliskiren reduces the production of angiotensin II by inhibiting renin, which leads to vasodilation and a reduction in blood pressure.
- Hydrochlorothiazide works as a diuretic, helping the kidneys eliminate excess sodium and water, which reduces blood volume and, in turn, lowers blood pressure.

This combination therapy is particularly beneficial for patients whose blood pressure is not adequately controlled by monotherapy (using only one of the drugs). It may also be used in resistant hypertension, where blood pressure remains high despite treatment with other medications.

Aliskiren Hemifumarate + Hydrochlorothiazide Contraindications - Important Warnings

Aliskiren Hemifumarate + Hydrochlorothiazide should not be used in the following conditions:
- Pregnancy: This combination is contraindicated in pregnant women, particularly after the first trimester. Use of Aliskiren during pregnancy can lead to fetal injury or death due to its effect on the renin-angiotensin system.
- Severe Renal Impairment: In patients with severe renal impairment (eGFR < 30 mL/min/1.73m²), the use of this combination can worsen kidney function. Aliskiren should not be used in such patients due to the increased risk of renal complications.
- Angioedema History: This combination should not be used in patients with a history of angioedema related to the use of ACE inhibitors or ARBs, as Aliskiren has been associated with similar risks of angioedema.
- Hypersensitivity: Any patient with known hypersensitivity or allergy to either Aliskiren or Hydrochlorothiazide, or to any of the excipients in the formulation, should avoid this medication.

Aliskiren Hemifumarate + Hydrochlorothiazide Side Effects - What to Expect

The common and severe side effects associated with Aliskiren Hemifumarate + Hydrochlorothiazide include:
- Hyperkalemia: Increased potassium levels are a serious risk, particularly with Aliskiren. Symptoms of hyperkalemia include fatigue, weakness, irregular heartbeats, and nausea.
- Hypotension: Especially after the first dose, hypotension can occur, with symptoms like dizziness, fainting, or lightheadedness.
- Electrolyte Imbalance: Hydrochlorothiazide can cause hypokalemia (low potassium), hyponatremia (low sodium), and hypomagnesemia. Symptoms may include muscle cramps, fatigue, and irregular heart rhythms.
- Kidney Dysfunction: Both medications can affect kidney function, and renal impairment may be a side effect, potentially leading to acute renal failure.
- Angioedema: A rare but serious side effect, angioedema (swelling of the face, lips, or throat) can occur, particularly with Aliskiren.
- Cough: Although less common than with ACE inhibitors, some patients may experience a dry cough as a side effect of Aliskiren.
- Rash: Skin reactions such as a rash or itching may occur in some individuals.
- Fatigue or Weakness: Patients may experience generalized fatigue or weakness, especially if electrolyte levels are disturbed.
- Gastrointestinal Issues: Nausea, diarrhea, or stomach discomfort can occur with either drug.

Aliskiren Hemifumarate + Hydrochlorothiazide Pregnancy Category ID - Safety Information

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Aliskiren Hemifumarate + Hydrochlorothiazide Mode of Action - How It Works

Aliskiren Hemifumarate works as a direct renin inhibitor. By inhibiting renin, it blocks the conversion of angiotensinogen to angiotensin I, which in turn reduces the production of angiotensin II, a potent vasoconstrictor. This leads to vasodilation and a reduction in blood pressure. Hydrochlorothiazide works as a thiazide diuretic, promoting sodium and water excretion by the kidneys, which reduces blood volume and helps lower blood pressure. The combination of these two mechanisms provides a complementary approach to controlling hypertension.

Aliskiren Hemifumarate + Hydrochlorothiazide Drug Interactions - What to Avoid

The combination of Aliskiren Hemifumarate and Hydrochlorothiazide may interact with several other medications and substances:
- Potassium-Sparing Diuretics and Supplements: Combining Aliskiren with other medications that increase potassium levels (such as spironolactone, amiloride, or potassium supplements) can increase the risk of hyperkalemia. Monitoring of potassium levels is essential.
- Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): The use of NSAIDs (e.g., ibuprofen, naproxen) with Aliskiren may reduce the blood pressure-lowering effect and increase the risk of renal impairment.
- Lithium: Aliskiren and Hydrochlorothiazide may increase lithium levels, raising the risk of lithium toxicity. If used together, lithium levels should be closely monitored.
- ACE Inhibitors/ARBs: Combining Aliskiren with ACE inhibitors or ARBs in patients with diabetes or kidney disease can significantly increase the risk of hyperkalemia and renal impairment, and this combination should generally be avoided.
- Corticosteroids: Hydrochlorothiazide may increase the risk of hypokalemia when used with corticosteroids, so potassium levels should be monitored.
- Alcohol: Alcohol can enhance the blood pressure-lowering effects of Aliskiren and Hydrochlorothiazide, increasing the risk of hypotension.

Aliskiren Hemifumarate + Hydrochlorothiazide Adult Dose - Recommended Dosage

The usual starting dose of Aliskiren Hemifumarate + Hydrochlorothiazide is 150/12.5 mg once daily. Depending on the patient's response and tolerability, the dose may be increased to 300/12.5 mg or 300/25 mg daily. It is recommended to take the medication in the morning, with or without food. Dose adjustments should be made cautiously, especially in patients with renal impairment, and blood pressure should be monitored regularly.

Aliskiren Hemifumarate + Hydrochlorothiazide Child Dose - Dosage for Children

The combination of Aliskiren Hemifumarate + Hydrochlorothiazide is not approved for use in children under the age of 18 years. Pediatric dosing and safety have not been well-established, and other antihypertensive treatments should be considered for children with hypertension.

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Important Note:
Before beginning treatment with Aliskiren Hemifumarate + Hydrochlorothiazide, it is crucial to consult with a healthcare provider to ensure the medication is safe for your specific condition and to monitor blood pressure, renal function, and electrolyte levels regularly.

Aliskiren Hemifumarate + Hydrochlorothiazide Renal Dose - Dosage for Kidney Conditions

For patients with renal impairment, dose adjustments are necessary. In patients with mild to moderate renal impairment (eGFR ≥ 30 mL/min/1.73m² but < 60 mL/min/1.73m²), the starting dose of Aliskiren Hemifumarate + Hydrochlorothiazide should be 150/12.5 mg once daily, with careful monitoring of renal function and serum electrolytes. In patients with severe renal impairment (eGFR < 30 mL/min/1.73m²), the use of this combination is not recommended due to the risk of further kidney damage.