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Sacubitril/Valsartan is available as an oral tablet in the following strengths:

• 24 mg/26 mg
• 49 mg/51 mg
• 97 mg/103 mg

Sacubitril/Valsartan is an angiotensin receptor-neprilysin inhibitor (ARNI) and is used to treat heart failure in people ages 1 year or older.

Sacubitril/Valsartan is a combination of two medications that work together to treat heart failure. Together, they’re known as an angiotensin receptor-neprilysin inhibitor (ARNI). Sacubitril is a neprilysin inhibitor. It works by blocking a protein in your body called neprilysin. This prevents the breakdown of substances called natriuretic peptides. These help relax your blood vessels and lower your blood pressure. They’re important for preventing worsening of heart failure. Valsartan is an angiotensin receptor blocker (ARB). It blocks angiotensin II, a hormone that narrows blood vessels. In doing so, valsartan relaxes blood vessels, which lowers your blood pressure and allows more blood to get to your heart and other organs.

Sacubitril/Valsartan is dosed as follows:

Adults:

• The typical starting dose is 49 mg/51 mg (Sacubitril/Valsartan) by mouth twice a day.
• Your provider will raise your dose every 2-4 weeks, as needed
• The typical maintenance dose is 97/103 mg (Sacubitril/Valsartan) twice a day

Children:

• Your provider will determine your child’s dose based on their body weight. If needed, they’ll adjust your child’s dose every 2 weeks
• Weight less than 88 lbs: The dose is calculated based on the combined amount of sacubitril and valsartan in the oral liquid. The typical dose starting dose is 1.6 mg/kg by mouth twice daily. The typical maintenance dose is 3.1 mg/kg twice daily
• Weight 88 lbs to less than 110 lbs: The typical starting dose is 24 mg/26 mg (Sacubitril/Valsartan) by mouth twice daily. The typical maintenance dose is 72 mg/78 mg (Sacubitril/Valsartan) twice daily
• Weight of 110 lbs or more: The typical starting dose is 49 mg/51 mg (Sacubitril/Valsartan) by mouth twice a day. The typical maintenance dose is 97/103 mg (Sacubitril/Valsartan) twice a day

Your dose might differ if you have kidney or liver problems, or if you’re not currently taking (or taking a low dose of) an angiotensin-converting enzyme (ACE) inhibitor or ARB.

Sacubitril/Valsartan is a safe and effective treatment when used for FDA licensed indications. However, like all medications, they may give you unwanted side effects. You should always discuss potential side effects with your physician to ensure the medication is suitable and right for you. You should not use this medication if any of the following apply:

• Hypersensitivity to any component
• History of angioedema related to previous ACEi or ARB therapy
• Concomitant use with ACE inhibitors
• Concomitant use with aliskiren in patients with diabetes

Common side effects of Sacubitril/Valsartan:

• Low blood pressure
• High potassium levels
• Cough
• Dizziness
• Kidney problems

Serious side effects are rare with Sacubitril/Valsartan. Contact your healthcare provider immediately if you experience any of the following.

• Angioedema: swelling of the eyes, face, tongue, throat, hands, feet, legs, or genitals
• Serious kidney problems: urinating less often than usual, swelling in your feet, ankles, or hands, unexplained weight gain
• High blood potassium levels: nausea, tiredness, chest pain, muscle weakness, tingling or numbness, pounding heart, nausea
• Severely low blood pressure: lightheadedness, dizziness, feeling faint, tiredness, confusion

The following medications may interact with Sacubitril/Valsartan:

• Avoid concomitant use with aliskiren in patients with eGFR < 60
• Potassium-sparing diuretics: May lead to increased serum potassium
• NSAIDs: May lead to increased risk of renal impairment
• Lithium: Increased risk of lithium toxicity

Various FDA-approved generic manufacturers

Sacubitril/Valsartan can harm or cause death to your unborn baby. Talk to your doctor about other ways to treat heart failure if you
plan to become pregnant. If you get pregnant during treatment with Sacubitril/Valsartan, tell your doctor right away. When pregnancy is detected, discontinue Sacubitril/Valsartan as soon as possible.

• Entresto