- Reduce risk of cardiovascular death and hospitalization in chronic heart failure (CHF):
- Converting from usual dose ACE inhibitor or ARB treatment:
- Initially PO 49mg/51mg BD, then increase dose after 2-4 weeks to 97mg/103mg BD
- For patients converting from ACE inhibitor, start 36 hours after discontinuing ACE inhibitor treatment
- Converting from usual dose ACE inhibitor or ARB treatment:
-
- Converting from low dose ACE inhibitor/ARB treatment:
- Initially 24mg/26mg BD then increase dose after 2-4 weeks to 49mg/51mg BD then increase dose after 2-4 weeks to 97mg/103mg BD
- Initially 24mg/26mg BD then increase dose after 2-4 weeks to 49mg/51mg BD then increase dose after 2-4 weeks to 97mg/103mg BD
- Converting from low dose ACE inhibitor/ARB treatment:
-
- Currently not receiving ACE inhibitor or ARB treatment:
- Initially 24mg/26mg BD then increase dose after 2-4 weeks to 49mg/51mg BD then increase dose after 2-4 weeks to 97mg/103mg BD
- Initially 24mg/26mg BD then increase dose after 2-4 weeks to 49mg/51mg BD then increase dose after 2-4 weeks to 97mg/103mg BD
- Currently not receiving ACE inhibitor or ARB treatment:
-
- eGFR < 30:
- Initially 24mg/26mg BD then increase dose after 2-4 weeks to 49mg/51mg BD then increase dose after 2-4 weeks to 97mg/103mg BD
- Initially 24mg/26mg BD then increase dose after 2-4 weeks to 49mg/51mg BD then increase dose after 2-4 weeks to 97mg/103mg BD
- eGFR < 30:
- Symptomatic heart failure with systemic left ventricular systolic dysfunction in pediatric patients aged ≥1 year:
- Converting from usual dose ACE inhibitor or ARB treatment
- <40 kg: Initially PO 1.6mg/kg/dose BD, then increase dose after 2 weeks to 2.3mg/kg/dose BD, then increase dose after 2 weeks to 3.1mg/kg/dose BD
- <40 kg: Initially PO 1.6mg/kg/dose BD, then increase dose after 2 weeks to 2.3mg/kg/dose BD, then increase dose after 2 weeks to 3.1mg/kg/dose BD
- Converting from usual dose ACE inhibitor or ARB treatment
-
-
- 40-50 kg: Initially PO 24mg/26mg BD, then increase dose after 2 weeks to 49mg/51mg BD, then increase dose after 2 weeks to 72mg/78mg BD
- 40-50 kg: Initially PO 24mg/26mg BD, then increase dose after 2 weeks to 49mg/51mg BD, then increase dose after 2 weeks to 72mg/78mg BD
-
-
-
- >50kg: Initially PO 49mg/51mg BD, then increase dose after 2 weeks to 72mg/78mg BD, then increase dose after 2 weeks to 97mg/103mg BD
- >50kg: Initially PO 49mg/51mg BD, then increase dose after 2 weeks to 72mg/78mg BD, then increase dose after 2 weeks to 97mg/103mg BD
-
-
- Currently not receiving ACE inhibitor or ARB treatment, or converting from low dose treatment
- <40 kg: Initially PO 0.8mg/kg/dose BD, then increase dose after 2 weeks to 1.6mg/kg/dose BD, then increase dose after 2 weeks to 2.3mg/kg/dose BD, then increase dose after 2 weeks to 3.1mg/kg/dose BD
- <40 kg: Initially PO 0.8mg/kg/dose BD, then increase dose after 2 weeks to 1.6mg/kg/dose BD, then increase dose after 2 weeks to 2.3mg/kg/dose BD, then increase dose after 2 weeks to 3.1mg/kg/dose BD
- Currently not receiving ACE inhibitor or ARB treatment, or converting from low dose treatment
-
-
- 40-50kg: Initially PO 0.8mg/kg/dose BD, then increase dose after 2 weeks to 24mg/26mg BD, then increase dose after 2 weeks to 49mg/51mg BD, then increase dose after 2 weeks to 72mg/78mg BD
- 40-50kg: Initially PO 0.8mg/kg/dose BD, then increase dose after 2 weeks to 24mg/26mg BD, then increase dose after 2 weeks to 49mg/51mg BD, then increase dose after 2 weeks to 72mg/78mg BD
-
-
-
- >50kg: Initially PO 24mg/26mg BD, then increase dose after 2 weeks to 49mg/51mg BD, then increase dose after 2 weeks to 72mg/78mg BD, then increase dose after 2 weeks to 97mg/103mg BD
-
- Tablet:
- 24mg/26mg
- 49mg/51mg
- 97mg/103mg
Taken without regards to meals
Sacubitril: Neprilysin inhibitor; It inhibits neprilysin, decreasing natriuretic peptide degradation
Valsartan: ARB; It selectively antagonizes angiotensin II AT1 receptors
- Hypotension
- Hyperkalemia
- Cough
- Dizziness
- Renal failure
- Diarrhea
- Arthralgia
- Fatigue
- Back pain
- Orthostatic hypotension
- Decreased Hb
- Decreased Hct
- Hypersensitivity to any component
- History of angioedema related to previous ACE inhibitor or ARB therapy
- Coadministration of neprilysin inhibitors with ACE inhibitors may increase angioedema risk
- Pregnancy
WARNING
Risk of fetal/neonatal morbidity/mortality
- Aliskiren
- Benazepril
- Captopril
- Enalapril
- Enalaprilat
- Fosinopril
- Grazoprevir
- Isocarboxazid
- Lisinopril
- Moexipril
- Perindopril
- Quinapril
- Ramipril
- Trandolapril
Drug Status
| Availability | Prescription only |
| Pregnancy | Contraindicated |
| Breastfeeding | Not recommended |
| Schedule | Not controlled |
| BRAND NAME | STRENGTH | FORMULATION | PACK SIZE | MANUFACTURER | DISTRIBUTOR |
|---|---|---|---|---|---|
| Dicard 100 | 49mg/51mg | Tablet | 30’s | Cosmos Ltd | Cosmos Ltd |
| Dicard 200 | 97mg/103mg | Tablet | 30’s | Cosmos Ltd | Cosmos Ltd |
| Dicard 50 | 24mg/26mg | Tablet | 30’s | Cosmos Ltd | Cosmos Ltd |
| Secutril VT 100 | 49mg/51mg | Tablet | 14’s | Innocia Lifesciences | Wessex Pharma |
| Secutril-VT 50 | 24mg/26mg | Tablet | 14’s | Innocia Lifesciences | Wessex Pharma |
| Secutril-VT 200 | 97mg/103mg | Tablet | 14’s | Innocia Lifesciences | Wessex Pharma |
| Uperio 100 | 49mg/51mg | Tablet | 28’s | Novartis Pharma | Novartis Kenya |
| Uperio 200 | 97mg/103mg | Tablet | 28’s | Novartis Pharma | Novartis Kenya |
| Uperio 50 | 24mg/26mg | Tablet | 28’s | Novartis Pharma | Novartis Kenya |