Sacubitril/Valsartan Sodium Tablets (Entresto) is a new type of angiotensin receptor-neprilysin inhibitor (ARNI), mainly used for the treatment of chronic heart failure and hypertension. As a prescription drug, its use must strictly follow medical guidance. Fully understanding the medication precautions and monitoring requirements is crucial for ensuring its therapeutic effect and medication safety.
What Are the Medication Precautions for Sacubitril/Valsartan Sodium Tablets (Entresto)?
Strict Screening of Contraindicated Populations
Patients with a history of allergy to any component of this drug.
Patients who are currently using angiotensin-converting enzyme inhibitors (ACEIs) or have discontinued such drugs for less than 36 hours.
Patients with a past history of angioedema.
Diabetic patients who are currently using aliskiren (except for special cases).
Patients with severe hepatic impairment; pregnant women or women who may be pregnant.
Requirements for Special Medication Switching
When switching from angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin Ⅱ receptor antagonists (ARBs) to this drug, the previous type of drug must be discontinued at least 36 hours before starting treatment with this drug.
After the end of treatment with this drug, it is necessary to wait for more than 36 hours before starting to use angiotensin-converting enzyme inhibitors (ACEIs).
Dosage Adjustment for Special Populations
Patients with renal impairment: Must be used with caution under close monitoring.
Patients with hepatic impairment: Moderate to severe cases require special attention.
Elderly patients: Should start with a low dose and adjust gradually.
Strict Contraindications for Combined Medication
Angiotensin-converting enzyme inhibitors (ACEIs).
Aliskiren (for diabetic patients).
Medication Monitoring for Sacubitril/Valsartan Sodium Tablets (Entresto)
Monitoring for Angioedema
The incidence of angioedema is approximately 0.2%, mainly manifested as symptoms such as swelling of the tongue, glottis, and larynx.
Once detected, the drug must be discontinued immediately, and appropriate measures such as epinephrine injection and ensuring airway patency should be taken.
Even if the angioedema symptoms disappear, the drug must not be re-administered.
Monitoring for Symptomatic Hypotension
The incidence of symptomatic hypotension is 8.8%. Special vigilance against hypotension is required when starting medication and increasing the dose, and the patient's condition should be closely observed.
Routine Monitoring Items
Renal function monitoring: The incidence of renal dysfunction is 2.4%, and the incidence of renal insufficiency is 0.6%.
Serum potassium level monitoring: The incidence of hyperkalemia is 3.9%.
Hepatic function monitoring: Regularly check indicators such as AST and ALT.
