Two medicines, side by side
Aliskiren vs brimonidine/timolol
Aliskiren is labeled for high blood pressure; brimonidine/timolol for glaucoma. Their labels share no use, so they are not alternatives to each other. Drugs@FDA records approvals of aliskiren since 2007 and of brimonidine/timolol since 2007. Pharmacies paid $3.94 per aliskiren 150 mg tablet and $2.15 per mL (Brimonidine-timolol 0.2%-0.5%) (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. In FDA's classes, aliskiren is a renin inhibitor and brimonidine/timolol a beta-adrenergic blocker.
Check it at the source: the aliskiren FDA label on DailyMed (effective March 7, 2024); the brimonidine/timolol FDA label on DailyMed (effective March 17, 2026).
Highlights of the aliskiren record
Aliskiren (Tekturna) · label of March 7, 2024
FETAL TOXICITY When pregnancy is detected, discontinue Tekturna as soon as possible. ( 5.1 , 8.1 ) Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus. ( 5.1 , 8.1 ) WARNING: FETAL TOXICITY See full prescribing information for complete boxed warning. When pregnancy is detected, discontinue Tekturna as soon as possible. ( 5.1 , 8.1 ) Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus.
Used for
From the label: indicationsTekturna is a renin inhibitor (RI) indicated for the treatment of hypertension in adults and in pediatric patients weighing 50 kg or greater who are at least 6 years of age, to lower blood pressure. Lowering blood pressure reduces the risk of fatal and nonfatal cardiovascular events, primarily strokes and myocardial infarctions. […]
On the market
- Earliest approval on file
- March 5, 2007
- Generic labelers
- 1 labeler
- Pharmacy cost
- $3.94 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 0
Highlights of the brimonidine and timolol record
Brimonidine and timolol (Combigan) · label of March 17, 2026
Used for
From the label: indicationsCOMBIGAN ® is indicated for the reduction of elevated intraocular pressure (IOP) in patients with glaucoma or ocular hypertension who require adjunctive or replacement therapy due to inadequately controlled IOP. […]
On the market
- Earliest approval on file
- October 30, 2007
- Generic labelers
- 14 labelers
- Pharmacy cost
- $2.15 per mL
Supply and safety
- Shortage
- No current entry
- Recalls
- 5
Source: FDA drug labels via openFDA (Aliskiren label of March 7, 2024, Brimonidine/timolol label of March 17, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do aliskiren and brimonidine/timolol differ on the record?
In FDA's classes, aliskiren is a renin inhibitor and brimonidine/timolol a beta-adrenergic blocker.
How each works, in its label's words: Aliskiren, “Renin is secreted by the kidney in response to decreases in blood volume and renal perfusion.”; Brimonidine/timolol, “COMBIGAN is comprised of two components: brimonidine tartrate and timolol.”
Half-life, in each label's words: Aliskiren, “12.3 Pharmacokinetics Aliskiren is poorly absorbed (bioavailability about 2.5%) with an approximate accumulation …”; Brimonidine/timolol, “Excretion In the crossover study in healthy volunteers, the plasma concentration of brimonidine declined with a …”
Only the aliskiren label carries a boxed warning.
Generics: aliskiren since 2019; brimonidine/timolol since 2022 (Drugs@FDA).
| Aliskiren | Brimonidine/timolol | |
|---|---|---|
| Labeled for | High blood pressure | Glaucoma |
| Pharmacologic class | Renin Inhibitor | alpha-Adrenergic Agonist, beta-Adrenergic Blocker |
| How it works (label) | Renin is secreted by the kidney in response to decreases in blood volume and renal perfusion. Renin cleaves angiotensinogen to form the inactive decapeptide angiotensin I (Ang I). | COMBIGAN is comprised of two components: brimonidine tartrate and timolol. Each of these two components decreases elevated intraocular pressure, whether or not associated with glaucoma. |
| Half-life (label) | 12.3 Pharmacokinetics Aliskiren is poorly absorbed (bioavailability about 2.5%) with an approximate accumulation half-life of 24 hours. | Excretion In the crossover study in healthy volunteers, the plasma concentration of brimonidine declined with a systemic half-life of approximately 3 hours. |
| Earliest approval on file (Drugs@FDA) | March 5, 2007 | October 30, 2007 |
| First generic approved | March 22, 2019 | April 4, 2022 |
| Generic labelers (NDC) | 1 labeler | 14 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $3.94 per tablet (Aliskiren 150 mg tablet) | $2.15 per mL (Brimonidine-timolol 0.2%-0.5%) |
| 12-month price change | -2% | -52% |
| Boxed warning | Yes | No |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 0 | 5 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 5,999 | 6,959 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What next?
- Alternatives to aliskiren
- every medicine labeled for the same conditions