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Sacubitril valsartan washout — GPhC CRA MCQ

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HardCardiovascular TherapeuticsSacubitril valsartan washoutGPhC CRA

A hospital discharge prescription includes sacubitril/valsartan to start tonight. The patient took ramipril this morning and has heart failure with reduced ejection fraction. What is the most appropriate alternative?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Query the prescription because an ACE inhibitor washout is needed

Sacubitril/valsartan must not be started soon after an ACE inhibitor because of increased angioedema risk. A washout period is required between stopping an ACE inhibitor and starting sacubitril/valsartan. The discharge plan should be clarified.

Reference: BNF