Each week we will aim to bring out a concise email that provides 4-5 key pieces of information addressing a specific issue in clinical therapeutics.
This week: Sacubitril/ Valsartan – commonly known by the brand name Entresto®
Julian Soriano, Clinical Pharmacist, Ward MM
Eosinophilic asthma is a sub-type of asthma usually found in those who develop asthma in adult hood. This type of asthma may not respond well to traditional treatments and can lead to air trapping, worsening of symptoms and frequent flare ups. It can have an impact on quality of life due to the persistent airway inflammation.
- Entresto® is a new combination medication that contains a Neprilysin inhibitor (sacubitril) and an Angiotensin Receptor Blocker or ARB (Valsartan) and is indicated for NYHA class II–IV Heart failure.
- The PIVOTAL trial showed that Sacubitril/Valsartan was superior to enalapril (an ACE inhibitor) at reducing hospitalisations and cardiovascular death in patients with heart failure.
- Sacubitril/Valsartan is initially started at 24/26mg and titrated upwards every 2-4 weeks up to 97/103mg if tolerated. Patients who are changing from an ARB or ACE inhibitor may start on the 49/51mg dose.
- Initiation of Sacubitril/Valsartan will require patients to cease their current ACE inhibitor or ARB. A 36-hour washout period is required when changing from an ACE Inhibitor.
- The side effect profile of Sacubitril/ Valsartan is very similar to that of an ACE inhibitor and includes dizziness, hyperkalaemia, renal impairment, postural hypotension and cough.
Please consider these issues when preparing or interpreting RMMR reports or education sessions. Contributions of content or suggested topics are welcome and should be sent directly to firstname.lastname@example.org.