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Perindopril and Aliskiren Interaction

Drug interaction information between Perindopril and Aliskiren.

Perindopril and Aliskiren have a documented major interaction in FDA labeling.

FDA drug labeling documents a major-severity interaction between Perindopril and Aliskiren. Major interactions are generally avoided, moderate ones may need monitoring or a dose adjustment, and minor ones are usually low-risk. This page shows the documented mechanism and guidance. Label-documented interactions are not a complete safety review, so always confirm your own medications with a pharmacist or doctor. Educational information, not medical advice.

Drug A

Perindopril

ACE Inhibitor

Drug B

Aliskiren

Direct Renin Inhibitor

How They Interact

Using these two drugs together puts too much stress on the system that controls blood pressure and kidney function. This can cause your blood pressure to drop too low and may lead to sudden kidney failure.

What To Do

Avoid taking these drugs together, especially if you have diabetes or existing kidney problems. Your doctor will need to check your blood work and blood pressure frequently if they are used.

FDA Label Information

7.8 Dual Blockade of the Renin-Angiotensin System (RAS) Dual blockade of the RAS with angiotensin receptor blockers, ACE inhibitors, or aliskiren is associated with increased risks of hypotension, hyperkalemia, and changes in renal function (including acute renal failure) compared to monotherapy. Do not co-administer aliskiren with perindopril erbumine in patients with diabetes. Avoid use of aliskiren with perindopril erbumine in patients with renal impairment (GFR <60 mL/min).

Perindopril Also Interacts With

View all Perindopril interactions →

Frequently Asked Questions

Can I take Perindopril and Aliskiren together?

This is a major interaction. Avoid taking these drugs together, especially if you have diabetes or existing kidney problems. Your doctor will need to check your blood work and blood pressure frequently if they are used.

How serious is the interaction between Perindopril and Aliskiren?

This interaction is classified as "major" severity by the FDA. Major interactions may be life-threatening or cause serious side effects.

Why do Perindopril and Aliskiren interact?

Using these two drugs together puts too much stress on the system that controls blood pressure and kidney function. This can cause your blood pressure to drop too low and may lead to sudden kidney failure.

Understanding the Perindopril and Aliskiren Interaction

FDA-approved prescribing information for these two drugs flags their combination as a major-severity interaction. Perindopril belongs to the ACE Inhibitor class and Aliskiren belongs to the Direct Renin Inhibitor class - two categories that can collide when co-prescribed. The mechanism described in FDA labeling is: Using these two drugs together puts too much stress on the system that controls blood pressure and kidney function. Severity tiers matter: major flags generally advise avoidance, moderate flags often require monitoring or dose adjustment, and minor flags may only call for awareness.

Context around a specific patient determines real-world impact. Perindopril has 9 total documented interactions on file in this dataset, and Aliskiren has 28. Each additional medication compounds the interaction surface, which is why pharmacists run full-profile checks rather than evaluating one pair at a time. FDA-derived guidance for this pair is: Avoid taking these drugs together, especially if you have diabetes or existing kidney problems. Timing of doses, renal and hepatic function, age, and other concurrent prescriptions all shape whether a labeled interaction matters clinically.

An interaction flag is not a verdict. A large share of labeled interactions are managed routinely in clinical practice, the fix may be as simple as spacing doses or adding a monitoring test. Others require the prescriber to choose a different medication entirely. This page surfaces FDA-sourced labeling and openFDA data for educational purposes only; it is not medical advice and cannot account for your full clinical picture. Never start, stop, or adjust either Perindopril or Aliskiren based on a web page, speak with your prescriber or pharmacist before making any change.

Sources: FDA Drug Labels (SPL) via openFDA (2026). This is for informational purposes only and is not medical advice. Always consult your healthcare provider about drug interactions.