sacubitril + valsartan at a glance
Medicine class
Angiotensin receptor neprilysin inhibitor (ARNI).
Licensed role
Symptomatic chronic heart failure with reduced systolic function in adults and eligible children aged one year or older.
Food
Tablets may be taken with or without food.
Routine checks
Blood pressure, kidney function and blood potassium require monitoring.
What is sacubitril + valsartan used for?
The selected UK products are licensed for:
Adults with symptomatic chronic heart failure and reduced ejection fraction.
Children and adolescents aged one year or older with symptomatic chronic heart failure and left ventricular systolic dysfunction.
How does sacubitril + valsartan work?
Sacubitril is converted to an active substance that inhibits neprilysin, increasing protective peptides that promote blood-vessel relaxation and sodium excretion. Valsartan blocks angiotensin II at AT1 receptors, reducing vasoconstriction, fluid retention and harmful cardiac remodelling.
How to take sacubitril + valsartan
Follow the prescribed product instructions. Swallow tablets with water; do not split or crush them. For granules, carefully open the capsule, sprinkle all contents onto a small amount of soft food and consume immediately. Do not swallow the capsule shell.
Tablets may be taken with or without food.
Discard opened capsule shells immediately.
Do not interchange formulations without instructions from the prescribing team.
sacubitril + valsartan side effects
Common or expected effects
- Low blood pressure, dizziness or faintness
- Raised blood potassium
- Changes in kidney function
- Cough
- Headache
- Diarrhoea or nausea
- Tiredness
- Anaemia
Get urgent medical advice
- Sudden swelling of the face, lips, tongue or throat, especially with breathing or swallowing difficulty
- Collapse or severe persistent faintness
- New hallucinations, paranoia or other marked changes in mental state
sacubitril + valsartan in pregnancy
Sacubitril + valsartan is not recommended in the first trimester and is contraindicated during the second and third trimesters. If planning pregnancy or if pregnancy occurs, contact the prescriber promptly for treatment review. Later-pregnancy exposure may require additional fetal monitoring.
sacubitril + valsartan while breastfeeding
Small amounts of sacubitril and its active metabolite have been measured in breast milk, but evidence about effects in infants is insufficient. Product information does not recommend use while breastfeeding; discuss alternative treatment or feeding options with the specialist team.
sacubitril + valsartan interactions
A prescriber or pharmacist should review all medicines, supplements and salt substitutes. Important examples include:
ACE inhibitors, such as ramipril, enalapril or lisinopril
Concomitant use is contraindicated because it increases angioedema risk; a defined washout period is required when switching.
Other angiotensin receptor blockers
Do not combine because sacubitril + valsartan already contains an ARB.
Aliskiren
The combination is not recommended and is contraindicated with diabetes or specified renal impairment because hypotension, hyperkalaemia and renal dysfunction may increase.
Common questions about sacubitril + valsartan
Answers are fully visible for fast scanning and source review.
What is sacubitril + valsartan used for?
It treats symptomatic chronic heart failure with reduced systolic function in adults and eligible children aged one year or older.
Is sacubitril + valsartan an ACE inhibitor?
No. It is an angiotensin receptor neprilysin inhibitor containing a neprilysin inhibitor and the ARB valsartan.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.