Adverse effects
Angioedema - The ADE of angioedema found in patients using Aliskiren is due to the inhibition of bradykinin degradation which occurs within the Renin-Angiotensin System (RAAS)
High blood potassium level (particularly when used with ACE inhibitors in diabetic patients)
Low blood pressure (particularly in volume-depleted patients)
Diarrhea and other GI symptoms
Headache
Dizziness
Cough

Contraindications
Pregnancy: Other drugs such as ACE inhibitors, also acting on the renin–angiotensin system, have been associated with fetal malformations and neonatal death. Angiotensin cannot be used in patients who are pregnant because it will result in disruption of normal fetal kidney development. Breastfeeding: During animal studies, the drug has been found present in milk. Aliskiren has been shown to increase the likelihood of adverse cardiovascular outcomes in patients with diabetes and kidney or heart disease. Drug interactions
Aliskiren is a minor inhibitor of substrate CYP3A4 and, more importantly, P-glycoprotein:

It reduces furosemide blood concentration. Atorvastatin may increase blood concentration, but no dose adjustment is needed. Due to possible interaction with ciclosporin, the use of ciclosporin and aliskiren at the same time is contraindicated. Caution should be exercised when aliskiren is administered with ketoconazole or other moderate P-glycoprotein inhibitors (itraconazole, clarithromycin, telithromycin, erythromycin, or amiodarone). Recommendations have been made to stop prescribing aliskiren-containing medicines to patients with diabetes (type 1 or type 2) or with moderate to severe kidney impairment who are also taking an ACE inhibitor or ARB. Such patients should consider alternative antihypertensive treatment as necessary. Mechanism of action
Aliskiren is an antagonist to renin. Renin, the first enzyme in the renin–angiotensin–aldosterone system, plays a role in blood pressure control.
It was originally attributed to mumps, but after further studies by Swedish doctor Jan G. Waldenström in 1937, it was classified as a distinct manifestation of sarcoidosis. See also
Darier–Roussy disease
Sarcoidosis
List of cutaneous conditions

Notes
Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 978-1-4160-2999-1. References


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