Skip to Main Content

++

INTRODUCTION

++

aliskiren (a-lis-ki-ren)

Tekturna

Classification

Therapeutic: antihypertensives

Pharmacologic: direct renin inhibitor

++
Indications
++

Treatment of hypertension (alone or with other agents).

++
Action
++

Inhibition of renin results in decreased formation of angiotensin II, a powerful vasoconstrictor. Therapeutic Effects: Decreased blood pressure.

++
Adverse Reactions/Side Effects
++

Resp: cough. GI: abdominal pain, diarrhea ↑ (in females and elderly), dyspepsia, reflux. Misc: ANGIOEDEMA.

++

PHYSICAL THERAPY IMPLICATIONS

++
Examination and Evaluation
++

  • Monitor signs of angioedema including rashes, raised patches of red or white skin (welts), burning/itching skin, swelling in the face, and difficulty breathing. Notify physician of these signs immediately.

  • Assess blood pressure periodically, and compare to normal values (see Appendix F) to help document antihypertensive effects.

++
Interventions
++

  • Avoid physical therapy interventions that cause systemic vasodilation (large whirlpool, Hubbard tank). Additive effects of this drug and the intervention may cause a dangerous fall in blood pressure.

++
Patient/Client-Related Instruction
++

  • Remind patients to take medication as directed to control hypertension even if they are asymptomatic.

  • Counsel patients about additional interventions to help control blood pressure, including regular exercise, weight loss, sodium restriction, stress reduction, moderation of alcohol consumption, and smoking cessation.

  • Instruct patient to notify physician of a prolonged dry cough; drug therapy may need to be altered to resolve this side effect.

  • Instruct patient or family/caregivers to report severe or prolonged GI problems such as diarrhea, indigestion, heartburn, and abdominal pain.

++
Pharmacokinetics
++

Absorption: Poorly absorbed (bioavailability 2.5%).

++

Distribution: Unknown.

++

Metabolism and Excretion: 2% excreted unchanged in urine, remainder is probably metabolized (CYP3A4 enzyme system).

++

Half-life: 24 hr.

++

Table Graphic Jump Location
Favorite Table | Download (.pdf) | Print

TIME/ACTION PROFILE (antihypertensive effect)

ROUTE ONSET PEAK DURATION
PO unknown 2 wk 24 hr

++
Contraindications/Precautions
++

Contraindicated in: Hypersensitivity; OB: May cause fetal injury or death; Concurrent use with cyclosporine.

++

Use Cautiously in: Salt or volume depletion (correct before use); Severe renal impairment; Pedi: Safety not established.

++
Interactions
++

Drug-Drug: Blood levels are ↓ by irbesartan. Blood levels are ↑ by atorvastatin, ketoconazole, and cyclosporine (concurrent use with cyclosporine not recommended). ↓ blood levels and may ↓ effects of furosemide. Antihypertensive effects may be ↑ by other antihypertensives, diuretics, and nitrates. ↑ risk of hyperkalemia with concurrent use of ACE inhibitors, angiotensin II receptor antagonists, potassium supplements, potassium-sparing diuretics, or potassium-containing salt substitutes.

++

Drug-Food: High-fat meals significantly ↓ absorption.

++
Route/Dosage
++

PO (Adults): 150 mg/day initially; may be increased to 300 mg/day.

++
Availability
++

Tablets:...

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.