Entresto 50 mg 28 tablets
Composition:
Sacubitril is a neprilysin inhibitor. Increases the level of natriuretic peptides, which promotes vasodilation and sodium excretion.
Valsartan is an angiotensin II receptor antagonist, reduces blood pressure and the load on the heart.
Indications:
• Chronic heart failure (CHF) with reduced ejection fraction (HFrEF).
• Prescribed to patients in combination with standard therapy or as a replacement for it.
Dosage and method of administration:
Heart failure: The target dose of Entresto is 200 mg twice daily. The recommended starting dose of Entresto is 100 mg twice daily. A starting dose of 50 mg twice daily is recommended for patients not currently taking angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs), and should be considered for patients previously taking low doses of these drugs.
The Entresto dose should be doubled every 2 to 4 weeks to a target dose of 200 mg twice daily, based on patient tolerability. Due to the potential risk of angioedema with concomitant use of an ACE inhibitor, Entresto should not be started within 36 hours of discontinuing ACE inhibitor therapy.
Entresto should not be co-administered with ARBs due to Entresto’s angiotensin II receptor blocking activity.
If patients experience tolerability issues (symptomatic hypotension, hyperkalemia, renal impairment), concomitant medication adjustments or temporary dose reductions should be considered.
Essential hypertension: The recommended starting dose is 200 mg once daily. In patients whose blood pressure cannot be adequately controlled with Entresto 200 mg once daily, the dose can be increased to 400 mg once daily. In patients with hypertension and heart failure, the heart failure dosing is recommended.
Entresto can be used alone or in combination with other antihypertensive agents, with the exception of angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs).
Renal impairment: A starting dose of 50 mg twice daily is recommended for patients with heart failure and severe renal impairment (SCF <30 mL/min/1.73 m2). Caution is advised when using Entresto in these patients due to limited data. The safety and efficacy of Entresto in patients with essential hypertension and severe renal impairment (SCF <30 mL/min/1.73 m2) have not been established.
No dose adjustment is required in patients with mild (SCF 60-90 mL/min/1.73 m2) or moderate (SCF 30-60 mL/min/1.73 m2) renal impairment.
Hepatic impairment: A starting dose of 50 mg twice daily is recommended for patients with heart failure and moderate hepatic impairment. A starting dose of 100 mg once daily is recommended for patients with essential hypertension and moderate hepatic impairment. No dose adjustment is required when administering Entresto to patients with mild hepatic impairment.
