Drug Mnemonic

Aliskiren

Antihypertensive • Direct Renin Inhibitor • Treats Hypertension
April 27, 2026

A story built from the name aliskiren itself - so the mechanism of action, key side effects, and the way Step 1 actually tests it stick on the first read.

RxMnemonic Antihypertensive
Aliskiren
Antihypertensive • Direct Renin Inhibitor • Treats Hypertension
ALIS = Alice + KI = kill +REN = renin
Separate Aliskiren into ALIS (which sounds like ALICE), KI (which sounds like kill), and REN (which sounds like renin). Alice (ALIS) is so done with the RAAS system that she decides to kill (KI) renin (REN) directly. Not angiotensin I, not angiotensin II, but renin itself at the very first step. 
Aliskiren pharmacology mnemonic illustration
Antihypertensive ALIS = Alice | KI = kill | REN = renin
HOW STEP TESTS IT
1
Aliskiren is the only direct renin inhibitor and blocks the conversion of angiotensinogen to angiotensin I. 
2
Side effects include hyperkalemia and angioedema, and it is contraindicated in diabetic patients taking ACE inhibitors or ARBs. 
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Practice Question

A 61 year old man with T2DM is taking lisinopril 10 mg daily. The resident wants to intensify the RAAS blockade and considers adding aliskiren. What outcome is most likely with this combination?

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Pharmacology Summary

Aliskiren: Mechanism, Uses & High-Yield Facts for USMLE Step 1

Aliskiren is the only direct renin inhibitor currently available, blocking the first step of the RAAS cascade by preventing the conversion of angiotensinogen to angiotensin I. It is used for hypertension. Combining aliskiren with an ACE inhibitor or ARB in diabetic patients is contraindicated due to high risk of severe hyperkalemia, hypotension, and renal failure. Other notable side effects include angioedema and hyperkalemia.

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