Renin inhibitor
- Renin catalyzes the first and rate-limiting step of the renin-angiotensin system
- ↓ angiotensin I/II and aldosterone → BP lowering
- Same hyperkalemia/teratogenicity cautions as ACE inhibitors and ARBs
- Never combine with ACE inhibitors or ARBs in diabetes
Drugs with this mechanism (1)
- Aliskiren — Only direct renin inhibitor; no outcome advantage over ACE inhibitors or ARBs.
Self-check
- In which population must renin inhibitors not be combined with ACE inhibitors or ARBs?
People with diabetes. - Which downstream hormone falls with renin inhibition, besides angiotensin I/II?
Aldosterone.
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