Home Drug Guide Aliskiren Hemifumarate

Drug Guide

Generic Name

Aliskiren Hemifumarate

Brand Names Tekturna

Classification

Therapeutic: Antihypertensive

Pharmacological: Direct renin inhibitor

FDA Approved Indications

  • Treatment of hypertension

Mechanism of Action

Aliskiren inhibits renin enzymatic activity, thereby decreasing the formation of angiotensin I and subsequently angiotensin II, resulting in vasodilation and reduced blood pressure.

Dosage and Administration

Adult: Typically 150 mg once daily, can be increased to 300 mg once daily based on response.

Pediatric: Not approved for pediatric use.

Geriatric: No specific dosage adjustments, but monitor for hypersensitivity.

Renal Impairment: Adjustment may be necessary; use with caution.

Hepatic Impairment: Use with caution; no specific dose adjustment recommended.

Pharmacokinetics

Absorption: Well absorbed with bioavailability around 30%.

Distribution: Vast distribution; protein binding approximately 50%.

Metabolism: Primarily excreted unchanged; minimal metabolism.

Excretion: Excreted via feces and urine, mostly unchanged.

Half Life: Approximately 24 hours.

Contraindications

  • Pregnancy (second and third trimesters), bilateral renal artery stenosis, hypersensitivity to aliskiren.

Precautions

  • Use with caution in renal impairment, hypotension, and hyperkalemia.

Adverse Reactions - Common

  • Diarrhea (Unknown)
  • Dizziness (Common)
  • Cough (Uncommon)

Adverse Reactions - Serious

  • Angioedema (Rare)
  • Hyperkalemia (Uncommon)
  • Hypotension (Uncommon)

Drug-Drug Interactions

  • ACE inhibitors, ARBs, potassium-sparing diuretics (risk of hyperkalemia)

Drug-Food Interactions

  • Potassium-rich foods (risk of hyperkalemia)

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood pressure, renal function, and serum potassium periodically.

Diagnoses:

  • Ineffective tissue perfusion related to decreased blood pressure.

Implementation: Administer once daily, monitor for signs of hypotension and hyperkalemia.

Evaluation: Assess blood pressure response; adjust dose accordingly.

Patient/Family Teaching

  • Take medication as directed, even if feeling well.
  • Avoid potassium supplements and potassium-rich foods unless advised.
  • Report signs of angioedema, hyperkalemia, or severe dizziness.

Special Considerations

Black Box Warnings:

  • Pregnancy: Use during second and third trimesters can cause fetal injury and death.

Genetic Factors: None established.

Lab Test Interference: May increase serum creatinine and serum potassium levels.

Overdose Management

Signs/Symptoms: Severe hypotension, dizziness, nausea.

Treatment: Discontinue drug, provide supportive care, monitor vital signs, administer vasopressors if needed.

Storage and Handling

Storage: Store at room temperature between 20°C and 25°C.

Stability: Stable under recommended storage conditions.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.