How Do Renin Inhibitors Combos Work?

Renin-inhibitors combos are a class of drugs used for the treatment of hypertension (high blood pressure). Lowering high blood pressure helps in preventing cardiovascular events such as strokes (blockage in the blood supply to the brain) and myocardial infarctions (heart attacks), and kidney diseases.

Renin-inhibitors combos are a combination of two or three medicines that work together to lower blood pressure. 

• Aliskiren (a direct renin inhibitor): It affects the renin-angiotensin-aldosterone system by inhibiting proteolytic enzyme “renin” released by the kidneys and prevents renin from converting angiotensin to angiotensin I which is then converted to angiotensin II (a vasoconstrictor that causes high blood pressure). This inhibition of angiotensin II helps in the relaxation and widening of blood vessels and maintenance of proper blood flow.
• Hydrochlorothiazide (a thiazide diuretic or water pill): It reduces blood volume by inhibiting the sodium-chloride cotransporter in the kidneys, preventing sodium reabsorption, and inducing water excretion in the form of excess urine. 
• Amlodipine (a calcium channel blocker): It works by inhibiting calcium ion influx across cell membranes, with a greater effect on vascular smooth muscle cells that causes vasodilation (relaxing or widening the blood vessels) and a reduction in peripheral vascular resistance, thus lowering blood pressure and improving the blood flow to the heart.

Renin-inhibitors combos are administered via the oral route, typically once a day with or without food.

Renin inhibitors combos are indicated for the treatment of hypertension in adults:

• When one medicine to lower high blood pressure is not enough
• As the initial medicine to lower high blood pressure if the physician decides that more than one medicine is required

Side effects associated with renin inhibitor combos include:

• Nausea
• Vomiting
• Diarrhea
• Dryness of mouth
• Muscle cramps 
• Headache
• Abdominal pain
• Dry cough
• Arthralgia (pain in joints)
• Tiredness/weakness
• Decreased appetite
• Flu-like symptoms

Other rare side effects include:

• Dizziness 
• Fatigue 
• Hypotension (low blood pressure)
• Increased liver enzymes
• Increased creatinine 
• Abnormal vision
• Chest pain
• Vertigo 
• Difficulty breathing or swallowing
• Severe allergic reactions
• Angioedema (abrupt and short-lived swelling of the skin and mucous membranes)
• Rash/hives
• Swelling of the face/lips/tongue/throat/arms and legs
• Palpitation 
• Hyperkalemia (high blood potassium level)
• Toxic epidermal necrolysis (a life-threatening skin disorder characterized by a blistering and peeling of the skin)
• Stevens-Johnson syndrome (a rare, serious disorder of the skin and mucous membranes)
• Hyperuricemia (elevated uric acid level in the blood)
• Gastroesophageal reflux disease (burning sensation in the chest caused by the acid that flows up from the stomach to the esophagus)

Information contained herein is not intended to cover all possible side effects, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Check with your doctor or pharmacist to make sure these drugs do not cause any harm when you take them along with other medicines. Never stop taking your medication and never change your dose or frequency without consulting your doctor.

Generic and brand names of renin inhibitors combos include:

• Aliskiren/amlodipine/hydrochlorothiazide
• Amturnide
• Hydrochlorothiazide/aliskiren
• Tekturna HCT