Valsartan with Sacubitril

Indications & Dose:

Symptomatic chronic heart failure with reduced ejection fraction (in patients not currently taking an ACE inhibitor or angiotensin II receptor antagonist, or stabilised on low doses of either of these agents)

• BY MOUTH 


• Adult: Initially 26/24 mg twice daily for 3–4 weeks, increased if tolerated to 51/49 mg twice daily for 3–4 weeks, then increased if tolerated to 103/97 mg twice daily

Symptomatic chronic heart failure with reduced ejection fraction (in patients currently stabilised on an ACE inhibitor or angiotensin II receptor antagonist)

• BY MOUTH

Adult: Initially 51/49 mg twice daily for 2–4 weeks, increased if tolerated to 103/97 mg twice daily, consider a starting dose of 26/24 mg if systolic blood pressure less than 110mmHg

Contraindications:

 Concomitant use of ACE inhibitor (separate administration by 36 hours) . systolic blood pressure less than 100 mmHg

Side Effects:

Common or very common Anaemia . diarrhoea . gastritis . hypoglycaemia . hypokalaemia . nausea . vertigo

PREGNANCY Manufacturer advises avoid— toxicity with sacubitril in animal studies.

BREAST FEEDING Manufacturer advises avoid— present in milk in animal studies.

HEPATIC IMPAIRMENT Manufacturer advises starting dose of 26/24 mg twice daily in moderate impairment. Contraindicated in severe impairment.

RENAL IMPAIRMENT Manufacturer recommends a starting dose of 26/24mg twice daily if eGFR less than 30 mL/minute/1.73m2. Also consider this starting dose if eGFR 30 to 60 mL/minute/1.73m2. 

Cautions:

Precautions:

Interaction:

Appendix 1 (angiotensin-II receptor antagonists, sacubitril)

Warnings:

Adverse Effects:

Lactations:

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Counselling:

Side Effects Or Adverse Reactions:

Patient And Carer Advice: