How Do Renin Inhibitors Work?

Renin inhibitors or direct renin inhibitors are medications that affect the renin-angiotensin-aldosterone system and are used to treat high blood pressure. 

Renin is a proteolytic enzyme released by the kidney; it increases blood pressure by retaining water and sodium in the body whenever blood pressure or sodium delivery to the distal renal tubule decrease. 

Renin converts a hormone produced by liver angiotensinogen to angiotensin I and also converts hormone angiotensin I to angiotensin II, whereas angiotensin II activates the hormone aldosterone. Hormone angiotensin II narrows blood vessels leading to increased blood pressure. Hormone aldosterone is responsible for the retention of sodium and water and increases fluid and sodium content in the vascular system and this leads to high blood pressure. 

Aliskiren-a renin inhibitor works by binding and directly inhibiting renin and preventing the conversion of hormones that are responsible for increasing blood pressure. Aliskiren relaxes blood vessels, improves the free flow of blood, decreases blood volume following diuresis (removal of water), and reduces sympathetic activity, thus reducing blood pressure.

Renin inhibitors are given as oral tablets for the treatment of hypertension. 

Side effects associated with renin inhibitors include:

• Nausea and vomiting
• Diarrhea
• Rash
• Cough
• Hyperkalemia (increase in potassium levels in the blood)
• Severe hypotension (low blood pressure)
• Dizziness
• Headache
• Angioedema (accumulation of fluid cause swelling of the area below the skin or mucosa)
• Tiredness 
• Chest pain
• Rhabdomyolysis (muscle injury)
• Toxic epidermolysis (severe skin reaction)
• Hyponatremia (decreased sodium levels)
• Renal stones
• Increased serum creatinine
• Hyperuricemia (high uric acid levels in the blood)
• Anaphylaxis (life-threatening allergic reactions)

The 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 include:

• Aliskiren
• Tekturna