Aliskiren fumarate

CLINICAL USE


Renin inhibitor, used for hypertension and
diabetic nephropathy

DOSE IN NORMAL RENAL FUNCTION


150–300 mg once daily

PHARMACOKINETICS


  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :
    1219.6
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :
    47–51
  • %Excreted unchanged in urine &nbsp &nbsp :
    0.6
  • Volume of distribution (L/kg) &nbsp &nbsp &nbsp :
    135 litres
  • half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp :
    34–41/Unchanged

    DOSE IN RENAL IMPAIRMENT


    GFR (mL/MIN)


  • 20 to 50 &nbsp &nbsp : Dose as in normal renal function
  • 10 to 20 &nbsp &nbsp : Dose as in normal renal function
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp :
    Dose as in normal renal function

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES


  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:
    Unlikely to be dialysed. Dose as in
    normal renal function

  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :
    Unlikely to be dialysed. Dose as in
    normal renal function
  • HDF/high flux &nbsp :
    Unlikely to be dialysed. Dose as in
    normal renal function
  • CAV/VVHD &nbsp &nbsp &nbsp:
    Unlikely to be dialysed. Dose as in
    normal renal function

    IMPORTANT DRUG INTERACTIONS


    Potentially hazardous interactions with other drugs

  • Other antihypertensive agents: enhanced

    antihypertensive effect; concentration
    possibly reduced by irbesartan

  • Antifungals: plasma concentration of

    aliskiren increased by ketoconazole

  • Diuretics: may reduce concentration

    of furosemide; hyperkalaemia with
    potassium-sparing diuretics

  • Heparins: increased risk of hyperkalaemia
  • Potassium salts: increased risk of

    hyperkalaemia

    ADMINISTRATION


    Reconstition



    Route


    Oral

    Rate of Administration



    Comments



    OTHER INFORMATION

  • Potassium should be monitored in patients

    with renal impairment, diabetes or heart
    failure

  • Oral bioavailability is only 2–3%