Entresto 50mg 14pcs

Indications of Entresto 50

This combination is advised to reduce the risk of cardiovascular mortality and heart failure hospitalization in patients with chronic heart failure (NYHA Classes II–IV) and a decreased ejection fraction.

This combination is typically administered in conjunction with other heart failure therapies rather than an ACE inhibitor or other ARB.

Pharmacology

The neutral endopeptidase enkephalinase, which normally cleaves natriuretic peptides like atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), and c-type natriuretic peptide, is inhibited by sacubitril's active metabolite, LBQ657 (CNP). Under atrial and ventricular pressure, ANP and BNP are released, activating subsequent receptors and causing vasodilation, natriuresis, and diuresis. Other vasodilators and vasoconstrictor peptides like angiotensin I and II, endothelin 1, and amyloid beta protein are degraded by enkephalinase under normal circumstances. Therefore, the inhibition of neprilysin results in increased levels of vasoconstrictor hormones like angiotensin II as well as increased concentration and decreased degradation of endogenous natriuretic peptides. (However, it can cause angiotensin II to block its receptors, prevent vasoconstriction, and result in a decrease in vascular resistance when used in conjunction with valsartan.

Valsartan is an oral medication that belongs to a class of drugs called angiotensin receptor blockers (ARB). It is a specific orally active angiotensin II antagonist that acts on the AT1 subtype. The binding of angiotensin to its receptors causes blood vessels to narrow (vasoconstriction), which leads to increased blood pressure (hypertension). Valsartan blocks angiotensin II receptors. By blocking the effects of angiotensin, valsartan dilates blood vessels and lowers blood pressure without affecting pulse rate. The affinity of valsartan for the AT1 receptor is much greater than that of the AT2 receptor (about 20,000 times). It does not bind to or block other hormone receptors or ion channels that are known to be important for cardiovascular regulation. Elevated peptide levels are the cardiovascular and renal effects of sacubitril. As a result, enkephalinase typically breaks down these peptides.

Angiotensin receptor blockers are a class of drugs that includes the oral medication valsartan (ARB). It is a particular angiotensin II antagonist that is orally active and targets the AT1 subtype. Vasoconstriction, which occurs as a result of angiotensin II binding to its receptors, raises blood pressure (hypertension). A blocker of angiotensin II receptors is valsartan. Valsartan relaxes blood vessels and lowers blood pressure without slowing the heart rate by blocking the effects of angiotensin. Valsartan has a much higher affinity for the AT1 receptor than the AT2 receptor (about 20,000 times). Other hormone receptors and ion channels that are well-known to be crucial for controlling cardiovascular function are not bound to or blocked by it.

Dosage & Administration

• The 49/51 mg twice daily starting dose for this combination is advised.
• After two to four weeks, double the dosage of this mixture to the desired maintenance dose of 97/103 mg twice daily, as tolerated by the patient.
• Adjusting the dosage for patients who are not taking ACE inhibitors or ARBs or who have only ever taken low doses of these drugs.
• Patients who have never taken an ACE inhibitor or an angiotensin II receptor blocker (ARB) or who have only ever taken low doses of these medications are advised to start with a dose of 24/26 mg twice daily. Every two to four weeks, increase the dosage of this combination by doubling it until it reaches the patient's tolerated maintenance dose of 97/103 mg twice daily.
• When an ACE inhibitor is also being used concurrently, sacubitril and valsartan are contraindicated. A washout period of 36 hours should be allowed between the administration of Sacubitril and Valsartan and an ACE inhibitor if switching from one to the other.

Contraindications

• Contraindications apply to this combination:
• Patients' hypersensitivity to any component
• individuals who have a history of angioedema associated with a prior ACE inhibitor or ARB treatment using ACE inhibitors concurrently. In the 36 hours following the start or stop of an ACE inhibitor, do not take it.
• When taking aliskiren along with having diabetes

Side Effects of Entresto 50

Other parts of the labeling list clinically important adverse events, such as Hyperkalemia, Angioedema, Hypotension, Impaired Renal Function

Pregnancy & Lactation

Pregnancy: Inform female patients of reproductive age about the risks of using this combination while pregnant. Discuss treatment choices with women who are thinking about starting a family. Instruct patients to notify their doctors as soon as they get pregnant.

Lactation: There is no evidence on whether sacubitril/valsartan is present in human milk, the effects on a breastfed newborn, or the impact on milk production. Rat milk contains sacubitril/valsartan. Because of the risk of significant adverse effects in breastfed infants from exposure to sacubitril/valsartan, tell a nursing mother that breastfeeding is not recommended while she is on the drug.

Precautions & Warnings

Signs and symptoms of angioedema and hypotension should be observed

• In patients who are susceptible, renal function and potassium levels should be monitored.
• Use with particular populations:
• Pregnancy: Giving Sacubitril/Valsartan to a pregnant woman has the potential to harm the fetus.
• During lactation, the medication should be stopped.
• Children's use Pediatric patients' safety and effectiveness have not been determined.
• Elderly use: When compared to the general population, elderly (>65 years) or very elderly (>75 years) patients did not show any discernible pharmacokinetic differences.
• Hepatic dysfunction Use is not advised

Storage Conditions

Store at room temperature between 20°C to 25°C. Protect from moisture.