Two medicines, side by side
Aliskiren vs hydrochlorothiazide
Aliskiren and hydrochlorothiazide are both labeled for high blood pressure. Drugs@FDA records approvals of aliskiren since 2007 and of hydrochlorothiazide since 1959. Pharmacies paid $3.94 per aliskiren 150 mg tablet and $0.0115 per hydrochlorothiazide 25 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. Hydrochlorothiazide's other strengths are brand-only: $4.46 per mL (Inzirqo 10 mg/mL oral suspension). In FDA's classes, aliskiren is a renin inhibitor and hydrochlorothiazide a thiazide diuretic.
Check it at the source: the aliskiren FDA label on DailyMed (effective March 7, 2024); the hydrochlorothiazide FDA label on DailyMed (effective June 12, 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 hydrochlorothiazide record
Hydrochlorothiazide (Inzirqo) · label of June 12, 2026
Used for
From the label: indicationsHydrochlorothiazide tablets USP are indicated as adjunctive therapy in edema associated with congestive heart failure, hepatic cirrhosis, and corticosteroid and estrogen therapy. Hydrochlorothiazide tablets USP have also been found useful in edema due to various forms of renal dysfunction such as nephrotic syndrome, acute glomerulonephritis, and chronic renal failure. […]
On the market
- Earliest approval on file
- February 12, 1959
- Generic labelers
- 43 labelers
- Pharmacy cost
- $0.0115 per tablet
Supply and safety
- Shortage
- A presentation being discontinued
- Recalls
- 7
Source: FDA drug labels via openFDA (Aliskiren label of March 7, 2024, Hydrochlorothiazide label of June 12, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do aliskiren and hydrochlorothiazide differ on the record?
In FDA's classes, aliskiren is a renin inhibitor and hydrochlorothiazide a thiazide diuretic.
Half-life, in each label's words: Aliskiren, “12.3 Pharmacokinetics Aliskiren is poorly absorbed (bioavailability about 2.5%) with an approximate accumulation …”; Hydrochlorothiazide, “When plasma levels have been followed for at least 24 hours, the plasma half-life has been observed to vary between 5.6 …”
Only the aliskiren label carries a boxed warning.
Generics: aliskiren since 2019; hydrochlorothiazide since 1973 (Drugs@FDA).
| Aliskiren | Hydrochlorothiazide | |
|---|---|---|
| Labeled for | High blood pressure | Heart failure, High blood pressure, Edema (fluid retention) |
| Pharmacologic class | Renin Inhibitor | Thiazide Diuretic |
| 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). | n/a |
| Half-life (label) | 12.3 Pharmacokinetics Aliskiren is poorly absorbed (bioavailability about 2.5%) with an approximate accumulation half-life of 24 hours. | When plasma levels have been followed for at least 24 hours, the plasma half-life has been observed to vary between 5.6 and 14.8 hours. |
| Earliest approval on file (Drugs@FDA) | March 5, 2007 | February 12, 1959 |
| First generic approved | March 22, 2019 | January 12, 1973 |
| Generic labelers (NDC) | 1 labeler | 43 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $3.94 per tablet (Aliskiren 150 mg tablet) | $0.0115 per tablet (Hydrochlorothiazide 25 mg tablet) |
| 12-month price change | -2% | -7% |
| Boxed warning | Yes | No |
| Shortage now | No current entry | A presentation being discontinued |
| Recalls recorded | 0 | 7 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 5,999 | 144,413 |
| 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