Sacubitril / Valsartan (neprilysin inhibitor) – Mechanism & Side Effects [Cardiac Medications 24/26] [Video]

Sacubitril/valsartan is a medication that combines two active ingredients, sacubitril and valsartan, and is primarily used to treat heart failure. It’s sold under the brand name Entresto and has been approved by various regulatory agencies, including the U.S. Food and Drug Administration (FDA) and the European Medicines Agency (EMA), for the treatment of chronic heart failure in certain patients.

Here’s some information about each of the components and how they work together:

1. **Sacubitril**: Sacubitril is an angiotensin receptor-neprilysin inhibitor (ARNI). Neprilysin is an enzyme responsible for breaking down certain hormones, including natriuretic peptides, which play a role in promoting vasodilation (relaxation of blood vessels) and reducing fluid retention. By inhibiting neprilysin, sacubitril helps increase the levels of these beneficial hormones, leading to improved cardiovascular function.

2. **Valsartan**: Valsartan is an angiotensin II receptor blocker (ARB). Angiotensin II is a hormone that causes blood vessels to constrict and promotes the release of another hormone, aldosterone, which leads to fluid retention. Valsartan blocks the receptors that angiotensin II binds to, thus preventing its effects on blood vessels and reducing aldosterone release. This results in vasodilation and decreased fluid retention, which are beneficial for heart failure patients.

The combination of sacubitril and valsartan in a single medication like sacubitril/valsartan (Entresto) provides a dual mechanism of action. By simultaneously inhibiting neprilysin and blocking angiotensin II receptors, this medication helps improve the heart’s pumping ability, reduce fluid accumulation, and alleviate the symptoms of heart failure.

Entresto is typically prescribed for patients with chronic heart failure with reduced ejection fraction (HFrEF). Ejection fraction is a measure of the heart’s ability to pump blood. HFrEF indicates that the heart’s pumping function is impaired, and this condition can lead to symptoms like shortness of breath, fatigue, and fluid retention.

It’s important to note that sacubitril/valsartan can have side effects, including low blood pressure, elevated levels of potassium in the blood (hyperkalemia), and an increased risk of angioedema (a swelling of the deeper layers of the skin). Therefore, it’s prescribed under the guidance of a healthcare professional who will monitor the patient’s response and adjust the dosage as needed.

As with any medication, individuals should consult their healthcare provider before starting sacubitril/valsartan to ensure that it’s appropriate for their specific condition and medical history.