Meta Information
ID:aliskiren
Name:
Schema Version:AIM-2.0
Interactions
Target id:
/condition/pregnancy
Target name:
Pregnancy
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Aliskiren can cause injury and death to the developing fetus by acting directly on the renin-angiotensin system, which is critical for fetal development. This carries a boxed warning from the FDA.
Actionable advice:
Avoid completely during pregnancy; discontinue as soon as pregnancy is detected.
Target id:
/class/ace-inhibitors
Target name:
ACE Inhibitors
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Dual blockade of the renin-angiotensin system (RAAS) significantly increases the risk of hypotension (low blood pressure), hyperkalemia (high potassium), and acute kidney failure.
Actionable advice:
Avoid co-administration, especially in patients with diabetes or renal impairment (GFR < 60 mL/min).
Target id:
/class/arbs
Target name:
Angiotensin II Receptor Blockers (ARBs)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Dual blockade of the renin-angiotensin system (RAAS) significantly increases the risk of hypotension (low blood pressure), hyperkalemia (high potassium), and acute kidney failure.
Actionable advice:
Avoid co-administration, especially in patients with diabetes or renal impairment (GFR < 60 mL/min).
Target id:
/intervention/cyclosporine
Target name:
Cyclosporine
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Cyclosporine is a strong inhibitor of P-glycoprotein (P-gp), a transporter that removes aliskiren from the body, leading to a large increase in aliskiren blood levels and risk of toxicity.
Actionable advice:
Avoid this combination completely as it is contraindicated.
Target id:
/intervention/itraconazole
Target name:
Itraconazole
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Itraconazole is a strong inhibitor of P-glycoprotein (P-gp), a transporter that removes aliskiren from the body, leading to a large increase in aliskiren blood levels and risk of toxicity.
Actionable advice:
Avoid this combination completely as it is contraindicated.
Target id:
/dietary/high-fat-meal
Target name:
High-Fat Meal
Severity:
major
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
1
Hours after target:
2
Description:
A high-fat meal can decrease the absorption of aliskiren by up to 85%, severely reducing its effectiveness in controlling blood pressure.
Actionable advice:
Take aliskiren on an empty stomach or with a light, low-fat meal, and be consistent with your timing relative to food.
Target id:
/class/potassium-sparing-diuretics
Target name:
Potassium-Sparing Diuretics
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Combining aliskiren with drugs that retain potassium (like spironolactone or eplerenone) greatly increases the risk of developing dangerously high potassium levels (hyperkalemia).
Actionable advice:
Avoid this combination unless absolutely necessary and monitored closely by a physician.
Target id:
/intervention/potassium
Target name:
Potassium Supplements
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Aliskiren can increase serum potassium on its own; taking additional potassium supplements can lead to dangerously high potassium levels (hyperkalemia), which can affect heart rhythm.
Actionable advice:
Do not take potassium supplements unless directed and closely monitored by your doctor.
Target id:
/dietary/potassium-salt-substitutes
Target name:
Potassium-Containing Salt Substitutes
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Salt substitutes often contain potassium chloride, which acts like a potassium supplement and can lead to dangerously high potassium levels (hyperkalemia) when taken with aliskiren.
Actionable advice:
Avoid using salt substitutes that contain potassium.
Target id:
/class/nsaids
Target name:
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
NSAIDs (like ibuprofen or naproxen) can reduce the blood pressure-lowering effect of aliskiren and increase the risk of kidney damage, especially in the elderly or dehydrated individuals.
Actionable advice:
Avoid regular use of NSAIDs; consult a physician for pain management alternatives.
Target id:
/condition/renal-impairment
Target name:
Renal Impairment
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Patients with poor kidney function are at a higher risk for adverse effects like hyperkalemia and further decline in renal function when taking aliskiren.
Actionable advice:
Use with caution and under medical supervision; combination with ACEi/ARBs is contraindicated if GFR < 60 mL/min.
Target id:
/condition/diabetes-mellitus
Target name:
Diabetes Mellitus
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
In patients with diabetes, combining aliskiren with an ACE inhibitor or ARB is contraindicated due to a significantly increased risk of renal impairment, hyperkalemia, and hypotension.
Actionable advice:
Never combine aliskiren with an ACE inhibitor or ARB if you have diabetes.
Target id:
/biomarker/serum-potassium
Target name:
Serum Potassium Level
Severity:
major
Interaction type:
requirement
Nature:
absolute
Temporal spacing:
null
Description:
Aliskiren can cause hyperkalemia (high potassium), a potentially life-threatening condition. Regular monitoring is essential to detect this early.
Actionable advice:
Ensure your serum potassium is checked periodically, especially when starting therapy or changing doses.
Target id:
/biomarker/egfr
Target name:
Estimated Glomerular Filtration Rate (eGFR)
Severity:
major
Interaction type:
requirement
Nature:
absolute
Temporal spacing:
null
Description:
Aliskiren can affect kidney function, particularly in susceptible individuals. Monitoring eGFR and creatinine is crucial to ensure renal safety.
Actionable advice:
Ensure your kidney function (creatinine and eGFR) is checked periodically while on this medication.
Target id:
/dietary/grapefruit-pomelo
Target name:
Fruit Juices (e.g., Grapefruit, Orange, Apple)
Severity:
moderate
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
2
Hours after target:
4
Description:
Certain fruit juices inhibit organic anion-transporting polypeptides (OATPs) in the gut, which are necessary for aliskiren absorption, leading to lower drug levels and reduced effectiveness.
Actionable advice:
Avoid drinking fruit juices for at least 2 hours before and 4 hours after taking aliskiren.
Target id:
/class/immunosuppressants
Target name:
Calcineurin Inhibitors (e.g., Tacrolimus)
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Similar to cyclosporine, other calcineurin inhibitors can increase the risk of hyperkalemia and nephrotoxicity when combined with aliskiren.
Actionable advice:
Use this combination with extreme caution and under close medical supervision.
Target id:
/class/loop-diuretics
Target name:
Loop Diuretics (e.g., Furosemide)
Severity:
moderate
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
null
Description:
Aliskiren can reduce the peak concentration and overall exposure to furosemide, potentially decreasing its diuretic and blood pressure-lowering effects.
Actionable advice:
Monitor for reduced diuretic effectiveness if this combination is used.
Target id:
/condition/dehydration
Target name:
Dehydration or Volume Depletion
Severity:
moderate
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
In patients who are dehydrated (e.g., from diuretics, vomiting, or diarrhea), starting aliskiren can lead to a sharp drop in blood pressure (symptomatic hypotension).
Actionable advice:
Ensure you are well-hydrated before starting aliskiren and correct any volume depletion.
Target id:
/condition/history-of-angioedema
Target name:
History of Angioedema
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
Aliskiren can cause angioedema (swelling of the face, lips, tongue, or throat), which can be life-threatening. A prior history increases the risk of recurrence.
Actionable advice:
Avoid aliskiren if you have a history of angioedema related to RAAS inhibitors.
Target id:
/condition/lactation
Target name:
Breastfeeding (Lactation)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
null
Description:
It is not known if aliskiren is excreted in human milk, but due to the potential for serious adverse reactions in nursing infants, a decision should be made to discontinue nursing or the drug.
Actionable advice:
Do not breastfeed while taking aliskiren without consulting your physician.
Target id:
/intervention/atorvastatin
Target name:
Atorvastatin
Severity:
minor
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
null
Description:
Aliskiren may slightly decrease the levels of atorvastatin in the blood, though the clinical significance of this interaction is likely low.
Actionable advice:
No specific action is required, but be aware of this potential minor interaction.