Sacubitril
About Sacubitril
Sacubitril + VALSARTAN is a prescription medicine used to treat chronic heart failure with reduced ejection fraction (HFrEF) in adults. It is typically prescribed for patients with a left ventricular ejection fraction (LVEF) of 40% or less who have New York Heart Association (NYHA) class II–IV symptoms. It helps reduce the risk of cardiovascular death and hospitalisation due to heart failure while improving symptoms such as shortness of breath, fatigue, and reduced exercise capacity. This medicine combines two active ingredients that work together to reduce strain on the heart and improve its pumping ability.
For the best results, take Sacubitril exactly as prescribed by your healthcare provider and continue taking it regularly, even if you feel well. You can take this medicine with or without food, but taking it at the same time(s) each day helps maintain consistent levels in your body. Following a heart-healthy lifestyle, including limiting salt intake, staying physically active as advised by your doctor, and taking your other heart medications as prescribed, can further improve treatment outcomes.
While Sacubitril is generally well tolerated, some people may experience dizziness, low blood pressure, or a mild cough, especially when starting treatment or after a dose increase. Contact your doctor immediately if you develop swelling of the face, lips, tongue, or throat, difficulty breathing, severe dizziness, fainting, or signs of kidney problems.
Before taking Sacubitril, inform your doctor if you have kidney disease, liver disease, low blood pressure, high potassium levels, or a history of angioedema. Do not take this medicine if you have previously experienced angioedema related to an ACE inhibitor or ARB, or if you are pregnant, as it can seriously harm the unborn baby.
This medicine may interact with potassium supplements, potassium-containing salt substitutes, NSAID pain relievers, ACE inhibitors, aliskiren, and certain diuretics, which may increase the risk of side effects or reduce treatment effectiveness. If you are pregnant, planning to become pregnant, breastfeeding, or are an older adult, consult your healthcare provider before taking this medicine.
Uses of Sacubitril
Medicinal Benefits
Sacubitril + VALSARTAN helps improve heart function, relieve symptoms of chronic heart failure, and reduce the risk of serious complications. Clinical studies have shown that it lowers the risk of cardiovascular death and hospitalisation due to worsening heart failure compared with standard ACE inhibitor therapy. Key benefits include:
- Reduces the Risk of Hospitalisation: Regular use helps lower the risk of hospitalisation due to worsening heart failure.
- Supports Better Heart Function: Helps reduce the workload on the heart, allowing it to pump blood more efficiently and improving overall cardiovascular function.
- Improves Heart Failure Symptoms: Helps relieve symptoms such as shortness of breath, fatigue, and reduced exercise capacity, making daily activities easier to perform.
Directions for Use
- Sacubitril can be taken with or without food as advised by the doctor.
- Follow your doctor's instructions on the dosage and timing of this medication to ensure safety.
- Swallow Sacubitril as a whole with a glass of water.
- Do not chew, crush or break it.
Storage
Side Effects of Sacubitril
Common Side Effects (Usually mild):
- Dizziness or lightheadedness
- Low blood pressure
- Mild dry cough
- Increased potassium levels in the blood
Serious Side Effects (Call a doctor right away):
- Swelling of the face, lips, tongue, or throat (angioedema)
- Severe dizziness or fainting
- Signs of kidney problems, such as reduced urine output
- Muscle weakness, palpitations, or irregular heartbeat due to high potassium levels
Drug Warnings
- Follow the 36-hour rule: Do not take Sacubitril if you have taken an ACE inhibitor (such as lisinopril, enalapril, or ramipril) within the last 36 hours. Combining these medicines too close together can increase the risk of severe, life-threatening swelling of the face, throat, and airways (angioedema).
- Monitor your blood pressure regularly: Check your blood pressure at home and keep a record for your doctor. Contact your healthcare provider if your readings are consistently low or if you experience dizziness or fainting when standing.
- Attend routine blood tests: Keep all scheduled appointments so your doctor can monitor your kidney function and potassium levels to ensure Sacubitril remains safe and effective.
- Stand up slowly: Rise gradually from a sitting or lying position to reduce the risk of dizziness or fainting caused by a sudden drop in blood pressure.
Drug Interactions
Inform your doctor if you are using any of the following medicines, as they may interact with Sacubitril.
- ACE inhibitors: Taking these together with Sacubitril significantly increases the risk of severe swelling of the face, lips, tongue, and throat (angioedema). Always allow at least a 36-hour interval between these medicines.
- Potassium-sparing diuretics or potassium supplements: Combining these with Sacubitril can lead to dangerously high potassium levels in the blood, increasing the risk of abnormal heart rhythms.
- Nonsteroidal anti-inflammatory drugs (NSAIDs): Medicines such as ibuprofen or naproxen may reduce the effectiveness of Sacubitril and increase the risk of kidney damage.
- Lithium: Taking Sacubitril with lithium may increase lithium levels in the body, raising the risk of lithium toxicity.
- Aliskiren: Combining Sacubitril + VALSARTAN with aliskiren is contraindicated in patients with diabetes because it increases the risk of kidney problems, high potassium levels, and low blood pressure. It should also generally be avoided in patients with renal impairment.
Drug-Drug Interactions Checker List:
Safety Advice
Alcohol
cautionYou are recommended to avoid alcohol consumption while taking Sacubitril to avoid unpleasant side effects.
Pregnancy
unsafeSacubitril is not recommended for use during pregnancy. Please consult your doctor if you are pregnant; your doctor will prescribe alternate medicine.
Breast Feeding
unsafeAvoid taking Sacubitril if you are breastfeeding. Please consult your doctor if you are breastfeeding; your doctor will prescribe alternate medicine.
Driving
cautionSacubitril may cause dizziness, do not drive or operate heavy machinery if you feel dizzy.
Liver
cautionDose adjustment may be needed. Sacubitril should not be used in patients with severe liver disease. Please consult your doctor if you have any concerns regarding this.
Kidney
cautionDose adjustment may be needed. Sacubitril should be used with caution in patients with kidney disease. Please consult your doctor if you have any concerns regarding this.
Children
unsafeSacubitril is not recommended for children as the efficacy and safety have not been established.
Habit Forming
Diet & Lifestyle Advise
- Limit sodium intake: Follow a low-salt diet to help reduce fluid retention and decrease the workload on your heart.
- Monitor your weight daily: Weigh yourself at the same time each morning and report sudden weight gain (such as 2–3 pounds in one day or 5 pounds in one week) to your doctor, as it may indicate worsening heart failure.
- Stay physically active: Engage in regular, doctor-approved physical activities such as walking or cardiac rehabilitation exercises to improve heart health and physical endurance.
- Avoid potassium supplements unless prescribed: Since this medicine may increase potassium levels, avoid potassium-containing salt substitutes or supplements unless recommended by your healthcare provider.
- Take your medicines regularly and attend follow-up appointments: Monitor your blood pressure, kidney function, and potassium levels as advised by your doctor to ensure safe and effective treatment.
Patients Concern
Disease/Condition Glossary
Heart failure: Heart failure is a condition in which the heart is unable to pump blood as effectively as it should. Conditions such as coronary artery disease, arrhythmia, congenital heart defect, diabetes, overactive/underactive thyroid, or high blood pressure make the heart too weak to pump blood efficiently. Symptoms of heart failure include shortness of breath, rapid heartbeat, swollen legs, and fatigue. People with disease conditions such as diabetes, thyroid problems, anaemia, emphysema, and behavioural conditions like smoking and being overweight are at an increased risk of developing heart failure.
FAQs
Dizziness, particularly when standing up quickly (postural or orthostatic hypotension), is a common side effect of Sacubitril. Rise slowly from sitting or lying positions to reduce the chance of dizziness or fainting. Your doctor may also recommend monitoring your blood pressure regularly. If the dizziness is severe, persistent, or causes you to faint, contact your doctor immediately.
No. Even if your symptoms improve, continue taking Sacubitril exactly as prescribed unless your doctor tells you to stop. Heart failure is a long-term condition, and stopping treatment on your own may cause your symptoms to return or your heart function to worsen. Speak with your doctor before making any changes to your treatment.
No, you must not take Sacubitril if you are pregnant or planning to become pregnant. This medicine can cause severe injury, developmental issues, or death to an unborn baby. If you suspect you are pregnant, stop taking the medicine and talk to your doctor immediately.
While the medicine begins to work in your body within a few hours of your first dose, it may take several weeks of consistent use before you notice a physical improvement in your heart failure symptoms, such as having more energy or breathing easier. Talk to your doctor if you have concerns about your progress.
It is highly recommended to limit or completely avoid alcohol while using this medicine. Alcohol can lower your blood pressure further, increasing the risk of severe dizziness and fainting, and can also directly weaken your heart muscle. Talk to your doctor or pharmacist about safe choices.
Yes, you will need to undergo routine blood tests as prescribed by your healthcare provider. These tests allow your doctor to monitor your kidney function and measure your blood potassium levels to ensure the medication is working safely. Talk to your doctor if you have questions about your testing schedule.
It depends on the specific medication. While some blood pressure medicines can be taken together with this treatment, others, like ACE inhibitors, are extremely dangerous due to the high risk of severe swelling. Always provide your doctor with a complete list of all medications you take to avoid dangerous combinations.
Breastfeeding is not recommended while taking Sacubitril + VALSARTAN because it is not known whether the medicine passes into breast milk, and there is a potential risk to the infant. If you are breastfeeding or planning to breastfeed, discuss alternative treatment options with your doctor.
A cough can occur while taking Sacubitril + VALSARTAN, but it is less common than with ACE inhibitors. If you develop a persistent or bothersome cough, do not stop taking the medicine on your own. Talk to your doctor so they can determine the cause and decide whether any change in treatment is needed.
