ACE inhibitor in pregnancy — GPhC CRA MCQ
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Correct answer: A — Delay sacubitril/valsartan until the ACE-inhibitor washout is complete
An ACE inhibitor must be stopped for at least 36 hours before sacubitril/valsartan is started because combined neprilysin and ACE inhibition substantially increases angioedema risk. The fixed-dose product cannot be separated into components, and antihistamine does not make concurrent administration safe.
Reference: https://www.pharmacyregulation.org/students-and-trainees/pharmacist-education-and-training/registration-assessment