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💊intro to pharmacology review

Sacubitril/valsartan

Written by the Fiveable Content Team • Last updated September 2025
Written by the Fiveable Content Team • Last updated September 2025

Definition

Sacubitril/valsartan is a combination medication used primarily in the treatment of heart failure. It works by inhibiting neprilysin, an enzyme that breaks down natriuretic peptides, while valsartan is an angiotensin receptor blocker (ARB) that helps to relax blood vessels, lowering blood pressure and reducing the strain on the heart.

5 Must Know Facts For Your Next Test

  1. Sacubitril/valsartan is marketed under the brand name Entresto and was approved by the FDA in 2015 for treating heart failure with reduced ejection fraction.
  2. The combination of sacubitril and valsartan has been shown to significantly reduce the risk of hospitalization and cardiovascular death in patients with heart failure.
  3. The medication is typically prescribed alongside lifestyle changes and other heart failure treatments to maximize patient outcomes.
  4. Common side effects of sacubitril/valsartan include hypotension, hyperkalemia, and renal impairment, making monitoring necessary after starting therapy.
  5. Sacubitril/valsartan should not be used in combination with ACE inhibitors due to the risk of angioedema and increased side effects.

Review Questions

  • How does sacubitril/valsartan improve outcomes in patients with heart failure?
    • Sacubitril/valsartan improves outcomes in patients with heart failure by combining the effects of neprilysin inhibition and angiotensin receptor blockade. By inhibiting neprilysin, sacubitril increases levels of beneficial natriuretic peptides, which promote vasodilation and diuresis, thus reducing fluid overload. Meanwhile, valsartan blocks the action of angiotensin II, further reducing blood pressure and decreasing the workload on the heart. Together, these mechanisms help decrease hospitalizations and cardiovascular mortality.
  • What are the key safety considerations when prescribing sacubitril/valsartan, particularly concerning drug interactions?
    • When prescribing sacubitril/valsartan, key safety considerations include avoiding its use with ACE inhibitors due to a significant risk of angioedema. Additionally, it is essential to monitor kidney function and potassium levels since sacubitril/valsartan can cause hyperkalemia and renal impairment. Patients should be assessed for hypotension as well, especially when initiating treatment or adjusting dosages. Overall, careful monitoring helps ensure safe usage while maximizing therapeutic benefits.
  • Evaluate how the introduction of sacubitril/valsartan has changed the management strategies for heart failure and discuss its implications for future treatment options.
    • The introduction of sacubitril/valsartan has significantly changed management strategies for heart failure by providing a novel mechanism that enhances existing therapies. Its ability to reduce hospitalizations and mortality rates has prompted a shift towards more aggressive treatment approaches for heart failure patients, prioritizing medications that target both neurohormonal activation and volume overload. As ongoing research continues to explore its long-term benefits and potential uses in other cardiac conditions, sacubitril/valsartan may pave the way for new therapeutic paradigms that integrate multi-targeted therapies for improved patient outcomes.