Aliskiren and Hydrochlorothiazide

The combination of aliskiren and hydrochlorothiazide is used to treat hypertension, or high blood pressure.

Overview

High blood pressure puts extra strain on the workload of your circulatory system, such as your heart and arteries. This can cause physical damage, and over time your heart and arteries may cease to function properly. This can lead to damage in the blood vessels of organs such as your heart, brain, and kidneys, which can lead to medical problems such as heart failure, kidney failure, or even a stroke. Lowering chronic high blood pressure can help reduce the risks of heart attacks and strokes. Your doctor may prescribe this medication to treat conditions other than hypertension.

Aliskiren

Aliskiren is a renin inhibitor, which works by blocking enzymes in the body that produces substances which cause your blood vessels to tighten too much. When this enzyme is blocked, it helps your blood vessels relax, decreasing your blood pressure and increasing the amount of blood and oxygen that is delivered to your heart.

Hydrochlorothiazide

Hydrochlorothiazide is a thiazide diuretic, or water pill. This medication works by reducing the amount of water in the body, which increases the flow of urine. This helps to reduce blood pressure.

Conditions treated:

  • Hypertension

Type of Medicine:

  • Renin inhibitor
  • Thiazide diuretic

Side Effects

Like any drug or medication, the combination of aliskiren and hydrochlorothiazide can have unwanted effects on the body, in addition to its desired medical effects. If you experience any side effects of aliskiren and hydrochlorothiazide while taking this medication, inform your supervising or prescribing physician.

Mild Side Effects

The combination of aliskiren and hydrochlorothiazide can cause some mild side effects that may be unpleasant to many patients, but are not necessarily indicative of a more serious problem. These side effects are a result of your body reacting normally to the medication and may subside during treatment as your body adjusts. Your doctor may be able to suggest ways you can prevent or reduce some of these side effects. If these side effects persist, become stronger, or become too bothersome or disruptive, contact your healthcare professional. Patients taking aliskiren and hydrochlorothiazide may experience muscle stiffness, or a lack or loss of strength, or feeling of weakness or lassitude. You may experience difficulty when moving. You may experience a sensation of spinning or vertigo, or a feeling of constant movement of yourself or your surroundings.

Serious Side Effects

The combination of aliskiren and hydrochlorothiazide can cause some serious side effects that may be dangerous to your health, or which may be indicative of serious health problems triggered within the body by your medication. If you experience any of these symptoms while taking aliskiren and hydrochlorothiazide, contact your doctor immediately and seek medical attention. You may experience cold-like symptoms, such as a sore throat, difficulty with swallowing, occasional or a persistent cough, or a runny nose. You may experience gastrointestinal symptoms such as nausea, loss of appetite, diarrhea, or vomiting. You may experience flu-like symptoms such as chills, shivering, or a fever, or headaches, muscle aches and pains, or joint pain. Talk to your doctor if you experience unusual sweating, dizziness, a fast heartbeat, or trouble sleeping. Some patients may experience reactions such as hives, a skin rash, large hive-like swellings on extremities such as the face, eyelids, lips, tongue, throat, and arms, legs, hands, feet, or genitals, as well as puffiness or swelling of the face, eyes, lips, tongue, or eyelids. This may be accompanied by shortness of breath, or an unusual tightness in the chest. Seek medical help immediately if you experience eye pain or a decrease in vision.

Overdose Symptoms

When taking aliskiren and hydrochlorothiazide, an overdose may occur. If you experience these symptoms of an overdose of aliskiren and hydrochlorothiazide, seek emergency medical help immediately. Seek help if you experience symptoms such as dry mouth, suddenly increased thirst, and decreased urine output. Seek help if you experience an increase in heart rate, an irregular heart rate, or a weak pulse. Symptoms of an overdose can include rapid breathing, irritability, muscle cramps, edema or swelling in the face, ankles, or hands, a weakness or heaviness of the legs, and numbness, weakness, or tingling pain in the hands or feet. Symptoms may include unusually wrinkled skin, sunken eyes, or trembling. An overdose of aliskiren and hydrochlorothiazide can lead to seizures, fainting, and coma.

Side Effects of Aliskiren

While taking any compound medication with aliskiren as a part of the ingredients, it is useful to keep the side effects of aliskiren in mind. Aliskiren is known to cause some gastrointestinal symptoms such as acid or sour stomach, indigestion, mild abdominal cramps, nausea, and diarrhea. Aliskiren may cause mild side effects such as headaches, coughing, or some dizziness. While taking medications with aliskiren, you may experience symptoms of angioedema, a swelling of the lower layer of skin and tissue under some mucous membranes, which may include symptoms such as swelling of the face, mouth, and throat over a period of minutes or hours, itchy or painful skin or slight numbness in these areas, and hives. Serious symptoms of angioedema which require medical intervention include constriction of the airways, which can manifest as shortness of breath, wheezing, dizziness, gasping and dizziness.

Side Effects of Hydrochlorothiazide

Hydrochlorothiazide can have side effects when taken as part of a compound medication. Hydrochlorothiazide can cause headaches, nausea and vomiting, photosensitivity (light sensitivity that may manifest as severe skin sensitivity to sun, such as a rash or sunburn), or weight gain. If you experience these side effects, inform your physician. Hydrochlorothiazide can trigger more serious health conditions in some patients that may require medical intervention. You may experience hypokalemia, or low levels of potassium in the blood, which can manifest as a feeling of tiredness, a feeling of physical weakness, cramps in the legs, constipation, or an abnormal heart rhythm. Seek medical assistance immediately if you experience symptoms of hyperglycemia such as excessive thirst, blurred vision, unusually dry mouth, highly increased volume of urination, fatigue, excessive hunger, and tingling in your feet or heels. Seek medical attention if you experience symptoms of pancreatitis such as severe upper abdominal pain, burning pain radiating to your back, and nausea to the point of vomiting that becomes worse upon eating. You may experience symptoms of gout, such as a swollen, red, tender, and hot-feeling joints, particularly in the base of the big toe, heels, knees, wrists, and fingers.

Dosage

Standard dosage and frequency of dose for aliskiren and hydrochlorothiazide are provided by the manufacturers. Your doctor may prescribe you a different dosage or frequency of aliskiren and hydrochlorothiazide depending on your condition and needs. Always take your aliskiren and hydrochlorothiazide in the same dosage and frequency that your doctor has prescribed for you.

Aliskiren and hydrochlorothiazide is available in tablet form, often sold under the brand name Tekturna. Doses are available in 150/12.5 mg, 150/25 mg, 300/12.5 mg, and 300/25 mg, normally taken once a day. The initial dose is normally given at 150/12.5 mg, and can be titrated to a maximum of 300 mg/25 mg once daily. Aliskiren and hydrochlorothiazide can take up to four weeks to take effect.

Aliskiren and hydrochlorothiazide needs to be taken at the same time and in the same way, whether you take it with or without food. Before you start taking aliskiren and hydrochlorothiazide, talk to your doctor about a daily routine for this medication that works best for you. Consult your doctor if you intend to change the way you take this medication. Ingesting aliskiren and hydrochlorothiazide with a high-fat meal may decrease your body's ability to absorb this medication.

If you miss a dose of your aliskiren and hydrochlorothiazide, you should take it as quickly as possible. If it is nearly time for your next dose of aliskiren and hydrochlorothiazide, do not take an extra dose to make up for it. Skip your missed dose and take the next dose on schedule. Double dosing of aliskiren and hydrochlorothiazide can be dangerous to your health.

Major Drug Interactions

The combination of aliskiren and hydrochlorothiazide has not yet been tested for interactions with other drugs. However, each of the active ingredients in this compound do have known interactions with other drugs. Keep a list of all medications, drugs, and supplements you are taking or take regularly with you, whether they are prescription drugs or over-the-counter substances. Your doctor or pharmacist should be able to identify any potential interactions between your aliskiren and hydrochlorothiazide and any other drugs, medications, or supplements you are currently taking, could potentially take, or may be prescribed.

Aliskiren and hydrochlorothiazide can interact with NSAIDs, many diet aids, and many cough and cold products. Before you take any of these medications or begin using an over-the-counter medication or supplement, consult your doctor or pharmacist for any potential interactions.

Some drugs can cause hyperkalemia, or a dangerous increase of potassium level in the blood, when taken in conjunction with aliskiren and hydrochlorothiazide. These drugs include ACE inhibitors that dilate or widen your blood vessels, such as quinapril, benazepril, lisinopril, perindopril, captopril, moexipril, and enalapril.

Aliskiren Interactions

When taking this medication, you should avoid taking cyclosporine or itraconazole, or any angiotension receptor blockers. ACE inhibitors such as benazepril, captopril, enalapril, fosinopril, lisinopril, moexipril, perindopril, quinapril, ramipril, or trandolapril may trigger or aggravate serious side effects of medication containing aliskiren. Patients taking aliskiren medications along with furosemide should be monitored.

Some drugs can affect the removal of aliskiren from the body, which can alter the way aliskiren works on the body. These drugs include quinidine, cyclosporine, and itraconazole. If you are taking these drugs in conjunction with aliskiren and hydrochlorothiazide, consult your doctor.

Hydrochlorothiazide

When taking this medication, you may need to adjust your dosage of any anti-diabetic drugs such as insulin. Hydrochlorothiazide may increase the risk of lithium toxicity, so patients who take lithium medications or lithium derivatives will need their blood pressure monitored during usage. NSAIDs and COX-2 selective agents may block the effect of thiazide diuretics, so patients will need to be monitored to see if the diuretic is having its needed effect. Patients taking medications with ion-exchange resins such as cholestyramine or colestipol will need to discuss dosage schedule with their doctor, as taking hydrochlorothiazide at least four hours before or after the administration of ion-exchange medications may help minimize unwanted interaction.

Warnings

Dehydration

Some side effects of aliskiren and hydrochlorothiazide can lead to dehydration. This can cause you to lose water in the body, which can lead to low blood pressure. If you experience side effects such as nausea, vomiting, diarrhea, excessive sweating, dry mouth, or frequent urination, you may be at risk for dehydration. Check with your doctor if you become sick with any of these symptoms while taking this medicine. Sweating can also cause loss of water while taking this medicine, which can lead to these effects. If you exercise or go out in hot weather while you take this medicine, be sure to drink plenty of water and stay hydrated to avoid low blood pressure.

Dizziness

After the first dose of aliskiren and hydrochlorothiazide, you may experience dizziness, lightheadedness, or fainting. This may be magnified if you have also been taking a diuretic or water pill. Take your first dose when you do not have to drive, use machines, or perform other tasks that may be dangerous if you are impaired. Be sure that you know how you react to your regular dose of this medication before you are ready to perform these tasks. If you begin to feel dizzy during the course of the day, lie down so you don't faint or lose consciousness, then sit briefly before standing to help prevent further dizziness. If you faint or lose consciousness, contact your doctor immediately and seek medical assistance.

Blood and Urine Tests

Aliskiren and hydrochlorothiazide can cause health conditions that may not manifest obvious symptoms or side effects. These conditions include hyperuricemia, or high levels of uric acid in your blood, as well as hyperlipidemia, high levels of cholesterol and triglycerides in your blood. Your doctor will need to perform blood and urine tests on you regularly in order to check for these problems, as well as to make sure that your medication is working properly and that your condition is progressing as desired.

Pregnancy Warning

Aliskiren and hydrochlorothiazide have been proven to increase the risk of birth defects in fetuses, as well as to increase the risk of fetal or neonatal death. Use of aliskiren while pregnant has been shown to cause increased intrauterine deaths and prolonged gestation and labor in animals. Use of this medication during the second and third trimesters of a pregnancy can cause reduced fetal renal function and possible renal failure, fetal lung hypoplasia or malformation in tissue, fetal skeletal and skull deformations, hypotension, and death. Some elements of this medication can also be excreted into human breast milk. Patients who are pregnant or plan to become pregnant should discuss the use of aliskiren and hydrochlorothiazide with their doctor before starting use. Aliskiren and hydrochlorothiazide is not recommended for use by pregnant patients unless the benefit outweighs the risk to the fetus and no alternatives are possible. Patients who may become pregnant while using aliskiren and hydrochlorothiazide should use an effective birth control at all times to keep from getting pregnant. If you think you have conceived while using aliskiren and hydrochlorothiazide, tell your doctor immediately.

Allergic Reactions

Aliskiren and hydrochlorothiazide can cause an allergic reaction in some patients. If you experience signs of an allergic reaction, seek medical attention immediately. Some signs of an allergic reaction to aliskiren and hydrochlorothiazide include a rash, itching or swelling of the face, tongue, and throat, trouble breathing, and severe dizziness.

Other Warnings

Aliskiren and hydrochlorothiazide do not affect all patients immediately. It can take up to four weeks to see the full effects of the medication.

If you are on a salt-free or low-salt diet, or if you are using a salt substitute that includes potassium or potassium-sparing diuretics, talk with your doctor before using aliskiren and hydrochlorothiazide.

Patients taking lithium should inform their prescribing or supervising physician, as taking lithium along with aliskiren and hydrochlorothiazide may necessitate more frequent or thorough bloodwork tests and checks.

Patients who are 65 years of age or older should use aliskiren and hydrochlorothiazide with care, as they may experience more side effects.

Patients who are allergic to sulfa drugs should not take aliskiren and hydrochlorothiazide.

Storage

Aliskiren and hydrochlorothiazide may be distributed in bottles, or may be distributed as unit-dose blister packages that come in 10 strips of 10 tablets each. Protect tablets from moisture. Aliskiren and hydrochlorothiazide tablets should be stored at 77ºF for ideal conditions, but may be stored at room temperature or from 59ºF to 86ºF.

Summary

Aliskiren and hydrochlorothiazide is a compound medication used to manage high blood pressure or hypertension. Aliskiren is a renin inhibitor, which blocks enzymes in the body that produce vasoconstrictors, allowing your blood vessels to relax and improving the flow of blood and oxygen to the organs. Hydrochlorothiazide is a thiazide diuretic, which works by reducing the amount of water in the body, reducing blood pressure.

Aliskiren and hydrochlorothiazide can have unwanted side effects. All side effects of aliskiren and hydrochlorothiazide should be reported to your doctor.

Aliskiren and hydrochlorothiazide can cause mild such effects such as muscle stiffness, weakness, vertigo, or a sense of constant movement. These side effects should go away after your body adjusts to the medication.

More serious side effects of aliskiren and hydrochlorothiazide can include cold-like symptoms such as a cough or runny nose, or gastrointestinal distress such as nausea or diarrhea. You may experience fever, headaches or muscle aches, joint pain, chills and shivering, unusual sweating, or trouble sleeping. You may experience hives or hive-like swellings, edema or puffiness or swelling of the face and extremities, and shortness of breath or unusual tightness in the chest. If you experience these symptoms, contact your doctor and seek medical help immediately.

Overdose of aliskiren and hydrochlorothiazide can have serious effects. You may experience symptoms of dehydration, an increased heart rate or irregular heartbeat, weak pulse, rapid breathing, edema, muscle cramps, or tingling in the hands and feet. This can lead to seizures, fainting, and coma. If you experience these symptoms, get medical help immediately.

Aliskiren and hydrochlorothiazide come in tablet form, with dosages of up to 150/12.5 mg to 300/25 mg. This medication is taken once a day. When you take this medication, be sure to take it at the same time each day, and consistently with or without food. Avoid taking aliskiren and hydrochlorothiazide with high-fat meals.

Aliskiren and hydrochlorothiazide can cause dehydration, dizziness, and allergic reactions. Patients taking aliskiren and hydrochlorothiazide should get regular blood tests to check for unseen health problems.

Aliskiren and hydrochlorothiazide can cause birth defects or fetal death.

Resources
Last Reviewed:
December 10, 2017
Last Updated:
December 22, 2017