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ARNIO tablets (Sacubitril Valsartan ).

  • Sacubitril/ Valsartan 50/100/200 mg tablets.
  • To reduce the risk of cardiovascular death and hospitalization for heart failure in patients with chronic heart failure (NYHA Class II-IV) and reduced ejection fraction.
  • Sacubitril/valsartan is an orally administered supramolecular sodium salt complex of the neprilysin inhibitor prodrug sacubitril and the angiotensin receptor blocker (ARB) valsartan. Neprilysin is an enzyme expressed in the kidney and is responsible for the degradation of several endogenous substances. This is a novel combination in the management of Heart Failure as: Valsartan is an ARB and blocks activation of renin–angiotensin–aldosterone system (RAAS), Sacubitril, inhibits neprilysin and preserves Atrial natriuretic peptide (ANP).
  • The recommended starting dose of is 100 mg orally twice-daily. Double the dose after 2 to 4 weeks to the target maintenance dose of 200 mg twice daily.
  • 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.
  • Observe for signs and symptoms of angioedema and hypotension. Monitor renal function and potassium in susceptible patients.
  • When pregnancy is detected, consider alternative drug treatment and discontinue. However, if there is no appropriate alternative to therapy with drugs affecting the renin angiotensin system, and if the drug is considered lifesaving for the mother, advise a pregnant woman of the potential risk to the fetus. Breastfeeding is not recommended during treatment with Sacubitril/ Valsartan. Safety and effectiveness have not been established in pediatric patients less than 1 year of age.
  • 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
  • Hypotension, Impaired Renal Function, Hyperkalemia.
  • ARNI