The Medical Letter on Drugs and Therapeutics
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Aliskiren/Hydrochlorothiazide (Tekturna HCT) for Hypertension

Aliskiren (Tekturna – Novartis), the first direct renin inhibitor for treatment of hypertension,1 has been approved for use in a fixed-dose combination with the diuretic hydrochlorothiazide (Tekturna HCT – Novartis). Many angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) are also available in fixed-dose combinations with hydrochlorothiazide (HCTZ).

MECHANISM OF ACTION — Aliskiren binds and inhibits the catalytic site of renin, thereby preventing release of angiotensin I and reducing serum concentrations of angiotensin I, angiotensin II and aldosterone.2 Unlike ACE inhibitors and ARBs, which increase both plasma renin concentrations (PRC) and activity (PRA), aliskiren increases PRC, but suppresses PRA.3 HCTZ can cause secondary activation of the renin-angiotensin-aldosterone system (RAAS) and ... more      

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