Sacubitril/valsartan

Combination drug for heart failure

Sacubitril/valsartan
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Sacubitril/valsartan, sold under the brand name Entresto, is a combination medication used in the management of heart failure. It combines two active ingredients: sacubitril, a neprilysin inhibitor, and valsartan, an angiotensin II receptor blocker (ARB). This combination is used to reduce the risk of cardiovascular death and hospitalization for heart failure in patients with chronic heart failure.

Mechanism of Action

Sacubitril/valsartan works by combining the effects of its two components. Sacubitril inhibits the enzyme neprilysin, which is responsible for the breakdown of natriuretic peptides. These peptides help to reduce blood volume and pressure by promoting sodium excretion and vasodilation. Valsartan blocks the angiotensin II receptor, which prevents the vasoconstrictive and aldosterone-secreting effects of angiotensin II. Together, these actions help to reduce the workload on the heart and improve cardiac function.

Clinical Use

Sacubitril/valsartan is primarily used in the treatment of heart failure with reduced ejection fraction (HFrEF). It is indicated for patients who are symptomatic despite optimal treatment with an angiotensin-converting enzyme (ACE) inhibitor or an angiotensin II receptor blocker (ARB). The medication has been shown to reduce the risk of cardiovascular death and hospitalization for heart failure.

Administration

Sacubitril/valsartan is administered orally in tablet form. The dosage is typically adjusted based on the patient's previous treatment with ACE inhibitors or ARBs, as well as their renal function and blood pressure. It is important to note that sacubitril/valsartan should not be administered concomitantly with an ACE inhibitor due to the risk of angioedema.

Side Effects

Common side effects of sacubitril/valsartan include hypotension, hyperkalemia, and renal impairment. Patients may also experience dizziness, cough, and fatigue. Serious side effects can include angioedema, particularly in patients with a history of angioedema related to ACE inhibitor therapy.

Contraindications

Sacubitril/valsartan is contraindicated in patients with a history of angioedema related to previous ACE inhibitor or ARB therapy. It is also contraindicated in patients with severe hepatic impairment and during pregnancy due to the risk of fetal harm.

Related Pages

• Heart failure
• Angiotensin II receptor blocker
• Neprilysin
• Angioedema