Aliskiren and Sacubitril and valsartan interaction

Aliskiren and Sacubitril and valsartan: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.

Major

Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.

What the FDA labels say

From the Aliskiren label · effective 2022-12-30

Major

Do not use aliskiren with ARBs or ACEIs in patients with diabetes [see Warnings and Precautions (5.2) and Clinical Studies (14.3) ].

Contraindicationsby drug classView label on DailyMed
Major

Do not use with angiotensin receptor blockers (ARBs) or angiotensin-converting enzyme inhibitors (ACEIs) in patients with diabetes.

Contraindicationsby drug classView label on DailyMed
Major

Avoid concomitant use with ARBs or ACEIs particularly in patients with renal impairment [creatinine clearance (CrCl) <60 mL/min].

Warnings and precautionsby drug classView label on DailyMed
Major

Renal Impairment/Hyperkalemia/Hypotension when Aliskiren Tablets are Given in Combination with ARBs or ACEIs Aliskiren tablets are contraindicated in patients with diabetes who are receiving ARBs or ACEIs because of the increased risk of renal impairment, hyperkalemia, and hypotension.

Warnings and precautionsby drug classView label on DailyMed
Major

In general, avoid combined use of aliskiren with ACE inhibitors or ARBs, particularly in patients with creatinine clearance (CrCl) less than 60 mL/min [see Contraindications (4) , Drug Interactions (7) and Clinical Studies (14.3) ] .

Warnings and precautionsby drug classView label on DailyMed

From the Sacubitril and valsartan (ENTRESTO) label · effective 2026-07-06

Major

Do not administer within 36 hours of switching from or to an ACE inhibitor [see Drug Interactions (7.1)] with concomitant use of aliskiren in patients with diabetes [see Drug Interactions (7.1)] Hypersensitivity to any component.

Contraindicationsnames AliskirenView label on DailyMed
Major

Concomitant use with aliskiren in patients with diabetes.

Contraindicationsnames AliskirenView label on DailyMed
Major

Avoid concomitant use with aliskiren in patients with estimated glomerular filtration rate (eGFR) less than 60.

Drug interactionsnames AliskirenView label on DailyMed
Major

The concomitant use of ENTRESTO with aliskiren is contraindicated in patients with diabetes [see Contraindications (4)] .

Drug interactionsnames AliskirenView label on DailyMed
Major

Avoid use with aliskiren in patients with renal impairment (eGFR less than 60 mL/min/1.73 m 2 ).

Drug interactionsnames AliskirenView label on DailyMed

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.