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Letter to the editor
Editor, – Aliskiren is a novel antihypertensive drug that is an orally-active direct renin inhibitor (Aust Prescr 2009;32:132-5). Its action shares a common biological pathway with angiotensin-converting enzyme (ACE) inhibitors. However, it has been suggested in an article by Professor Duggan that some respiratory and vascular adverse events were less likely than with the older drugs (Aust Prescr 2009;32:135-8). The proposal was fairly reasonable based on the different molecular target of the two drug groups. However, post marketing experience revealed cases of aliskiren-associated angioedema and drug regulators implemented labelling changes and safety advice.1-3 Therefore, physicians should be vigilant for the first signs of angioedema in aliskiren users. The biological basis, exact frequency and risk factors of this potentially life-treating event are currently not well understood. Until evidence becomes available, aliskiren and probably other similar drugs should not be used in patients with previous episodes of ACE inhibitor-induced angioedema of any clinical presentation.
Dragan Milovanovic, Slobodan Jankovic, Dejana Ruzic Zecevic and Marko Folic
Department of Clinical Pharmacology, Medical Faculty and University Hospital
- Aliskiren (Rasilez): risk of angioedema and renal dysfunction. Drug Saf Update 2009;2:2.
- Tekturna (aliskiren) tablets. Safety labeling changes approved by FDA Center for Drug Evaluation and Research (CDER) November 2009.
- Aliskiren. New contraindication and warning. WHO Pharmaceuticals Newsletter 2009;2:1.