SACUBITRIL + VALSARTAN

Bivalirudin

Sacubitril + Valsartan is a combination drug that is used in the treatment of heart failure.

Sacubitril is a prodrug of sacubitrilat (LBQ-657). Its effect includes the inhibition of neprilysin, which is a neutral endopeptidase (NEP). This further increases the secretion of endogenous vasoactive peptides including natriuretic peptides, bradykinin and adrenomedullin.

Valsartan, on the other hand, is an angiotensin II type 1 (AT1) receptor blocker. It antagonizes AT1-induced vasoconstriction, aldosterone, catecholamine and arginine vasopressin release, water consumption, and hypertrophic response.

Uses

Sacubitril + Valsartan is used in the treatment of chronic heart failure with reduced ejection fraction.

Warnings

Do not use Sacubitril + Valsartan in people with the following conditions:

  • Hypersensitivity or history of angioedema
  • Biliary cirrhosis
  • Cholestasis
  • Concomitant use or use within 36 hours of ACE inhibitors or Angiotensin II Receptor Blockers (ARBs)
  • Concomitant use with aliskiren-containing products in patients with diabetes mellitus
  • Severe hepatic impairment (Child-Pugh class C)
  • Pregnancy

Side Effects

Sacubitril + Valsartan may give rise to the following side effects:

  • Anemia
  • Angioedema
  • Asthenia
  • Cough
  • Decreased renal function
  • Diarrhea
  • Dizziness
  • Fatigue
  • Gastritis
  • Headache
  • Hyperkalemia
  • Hypoglycemia
  • Hypokalemia
  • Hypotension
  • Increased serum creatinine
  • Nausea
  • Orthostatic hypotension
  • Kidney failure
  • Syncope
  • Vertigo

Precautions

Precautions

Special precautions should be observed by the following:

  • Patients with risk factors for hypotension (example salt- or volume depletion, heart attack)
  • Aortic/mitral stenosis
  • Risk factors for renal failure (example diabetes mellitus, hypoaldosteronism)
  • Moderate to severe kidney and moderate liver impairment (Child-Pugh class B)
  • Lactation

 

Interactions

Sacubitril + Valsartan may interact with the following medicines:

  • ACE inhibitors/ARBs
  • Aliskiren
  • Ciclosporin
  • Increased risk of hyperkalemia with potassium-sparing diuretics (example triamterene)
  • Lithium
  • Metformin
  • Mineralocorticoid antagonists (example spironolactone)
  • NSAIDs
  • OATP1B1
  • OATP1B3 substrates (example atorvastatin)
  • Potassium supplements
  • Potassium-containing salt substitutes (example heparin)
  • Rifampicin
  • Ritonavir
  • Sildenafil and other PDE5 inhibitors
  • Statins

Overdose & Brands

If you think you may have used Sacubitril + Valsartan more than the usual dose, seek medical help immediately.

Available Brands:

  • Entresto

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