2.5.5.3 Renin inhibitors

  • NICE NG136 Hypertension in adults: diagnosis and management – August 2019 concluded that there is insufficient evidence for aliskiren’s effectiveness to determine its suitability for use in with resistant hypertension.
  • The combination of aliskiren with ACE inhibitors or ARBs has been associated with serious adverse cardiovascular and renal outcomes. This combination is now contraindicated in all diabetic patients and non-diabetic patients with an estimated glomerular filtration rate (eGFR) <60 mL/min per 1.73 m2. In all other patient groups, aliskiren in combination with an ACE inhibitor or an ARB is not recommended.
  • Any use of aliskiren (either as monotherapy or in combination with other medicines) is no longer recommended in any patient with severe renal impairment: eGFR <30 mL/min per 1.73 m2.
  • For full details See MHRA drug safety update  ‘Aliskiren (Rasilez▼): risk of cardiovascular and renal adverse reactions’.