Aliskiren

Aliskiren
Clinical data
Trade names	Tekturna, Rasilez
AHFS/Drugs.com	Monograph
MedlinePlus	a607039
License data	EU EMA: by INN; US DailyMed: Aliskiren; US FDA: Tekturna;
Pregnancy; category	C in first trimester; D in second and third trimesters;
Routes of; administration	By mouth (tablets)
ATC code	C09XA02 (WHO) ; C09XA52 (WHO) (with HCT);
Legal status
Legal status	UK: POM (Prescription only); US: ℞-only;
Pharmacokinetic data
Bioavailability	Low (approximately 2.5%)
Metabolism	Hepatic, CYP3A4-mediated
Elimination half-life	24 hours
Excretion	Renal
Identifiers
	IUPAC name (2S,4S,5S,7S)-5-amino-N-(2-carbamoyl-2,2-dimethylethyl)-4-hydroxy-7-{[4-methoxy-3-(3-methoxypropoxy)phenyl]methyl}-8-methyl-2-(propan-2-yl)nonanamide;
CAS Number	173334-57-1 ;
PubChem CID	5493444;
IUPHAR/BPS	4812;
DrugBank	DB01258 ;
ChemSpider	4591452 ;
UNII	502FWN4Q32;
KEGG	D03208 ;
ChEBI	CHEBI:601027 ;
ChEMBL	ChEMBL1639 ;
PDB ligand	C41 (PDBe, RCSB PDB);
CompTox Dashboard (EPA)	DTXSID40891494 ;
ECHA InfoCard	100.127.451
Chemical and physical data
Formula	C30H53N3O6
Molar mass	551.769 g·mol−1
3D model (JSmol)	Interactive image;
	SMILES O=C(N)C(C)(C)CNC(=O)[C@H](C(C)C)C[C@H](O)[C@@H](N)C[C@@H](C(C)C)Cc1cc(OCCCOC)c(OC)cc1;
	InChI InChI=1S/C30H53N3O6/c1-19(2)22(14-21-10-11-26(38-8)27(15-21)39-13-9-12-37-7)16-24(31)25(34)17-23(20(3)4)28(35)33-18-30(5,6)29(32)36/h10-11,15,19-20,22-25,34H,9,12-14,16-18,31H2,1-8H3,(H2,32,36)(H,33,35)/t22-,23-,24-,25-/m0/s1 ; Key:UXOWGYHJODZGMF-QORCZRPOSA-N ;
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Aliskiren (brand names Tekturna and Rasilez) is the first in a class of drugs called direct renin inhibitors. It is used for essential (primary) hypertension. While used for high blood pressure, other better studied medications are typically recommended due to concerns of higher side effects and less evidence of benefit.

In December 2011, Novartis halted a trial of the drug after discovering increased nonfatal stroke, kidney complications, high blood potassium, and low blood pressure in people with diabetes and kidney problems.

As a result, in 2012:

A new contraindication was added to the product label concerning the use of aliskiren with angiotensin receptor blockers (ARBs) or angiotensin-converting enzyme inhibitors (ACEIs) in patients with diabetes because of the risk of kidney impairment, low blood pressure, and high levels of potassium in the blood.
A warning to avoid use of aliskiren with ARBs or ACEIs was also added for patients with moderate to severe kidney impairment (i.e., where glomerular filtration rate is less than 60 ml/min).
Novartis decided to stop marketing Valturna (aliskiren/valsartan).

Aliskiren was co-developed by the Swiss pharmaceutical companies Novartis and Speedel.