Entresto 50mg 14pcs

✔️ Entresto is a combination medication consisting of:

Sacubitril (Neprilysin Inhibitor)

• Inhibits neprilysin (NEP) via LBQ657, the active metabolite.
• Increases levels of natriuretic peptides (which help reduce fluid retention and lower blood pressure).

Valsartan (Angiotensin Receptor Blocker - ARB)

• Blocks angiotensin II type-1 (AT1) receptors, preventing the harmful effects of angiotensin II (a hormone that constricts blood vessels and raises blood pressure).
• Reduces aldosterone secretion, which helps lower fluid retention and improves heart function.

Together, these components enhance cardiovascular and renal function, providing significant benefits in heart failure management.

✔️ Dosage & Administration of Entresto 50

1. Adult Dosage (Heart Failure)

• Starting Dose: 49/51 mg taken twice daily.
• Titration: After 2 to 4 weeks, the dose is doubled to a target of 97/103 mg twice daily, if tolerated.

🔹 Lower Starting Dose (24/26 mg Twice Daily) is Recommended for:

• Patients not previously on ACE inhibitors (ACEi) or ARBs.
• Individuals with severe kidney impairment.
• Patients with moderate liver impairment.

2. Pediatric Dosage (Heart Failure in Children Aged 1 Year & Older)

✅ Weight-Based Dosage Adjustments

💡 Pediatric doses should be adjusted every 2 weeks, depending on the patient's response and tolerance.

🔹 Important: Always take under medical supervision and follow prescribed dosage adjustments.

✔️ 🚨 Caution is required when used with the following medications:

1. Renin-Angiotensin-Aldosterone System (RAAS) Inhibitors

• Should NOT be taken with ACE inhibitors or Aliskiren (in diabetic patients).
• Avoid using with other ARBs, as it can lead to excessive blood pressure reduction.

2. Potassium-Sparing Diuretics

• Increases potassium levels, requiring regular monitoring.

3. NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)

• May increase the risk of kidney damage, especially in elderly patients or those with kidney disease.

4. Lithium

• Increases lithium toxicity, leading to severe neurological side effects.

✔️ The most common side effects include:

• Angioedema (swelling of face, lips, throat)
• Hypotension (low blood pressure)
• Kidney function impairment
• Hyperkalemia (high potassium levels)
• Cough
• Dizziness

🚨 Seek immediate medical attention if you experience severe swelling (angioedema), difficulty breathing, or fainting.

✔️ ❌ Entresto is NOT suitable for patients with:

• Allergy to Sacubitril, Valsartan, or any ingredient in the formulation.
• History of angioedema due to previous use of ACE inhibitors or ARBs.
• Concomitant use of ACE inhibitors (must wait at least 36 hours before switching).
• Diabetic patients taking Aliskiren (risk of severe complications).

✔️ Overdose Management

Symptoms: 

The most common overdose effect is severe low blood pressure (hypotension).

• Treatment:
  • Supportive care (IV fluids, lying down with legs elevated).
  • Hemodialysis is NOT effective (due to high protein binding of the drug).

✔️ Pregnancy & Lactation

• Not recommended during pregnancy, as it may cause harm to the fetus.
• Breastfeeding mothers should avoid use, as it is unknown whether the drug passes into breast milk.️

✔️ Geriatric Use (65+ Years & 75+ Years)

• No significant differences in drug behavior were observed.
• Close monitoring is advised in elderly patients with kidney or liver conditions.

✔️ Hepatic (Liver) Impairment

• Mild (Child-Pugh A) → No dose adjustment needed.
• Moderate (Child-Pugh B) → Start with 24/26 mg twice daily and increase as tolerated.
• Severe (Child-Pugh C) → Use NOT recommended due to lack of safety data.

✔️ Renal (Kidney) Impairment

• Mild to Moderate (eGFR 30–90 mL/min/1.73m²) → No dose adjustment needed.
• Severe (eGFR <30 mL/min/1.73m²) → Start at 24/26 mg twice daily, increase gradually.

✔️ Precautions & Warnings

1. Risk of Angioedema → Do NOT use in patients with a history of severe swelling (angioedema).
2. Low Blood Pressure (Hypotension) → Monitor blood pressure regularly to avoid dizziness or fainting.
3. Kidney Function Monitoring → Patients with kidney disease require close monitoring.
4. Hyperkalemia (High Potassium Levels) → Regular blood tests are needed to prevent complications.
5. Do NOT take ACE inhibitors → Wait at least 36 hours after stopping an ACE inhibitor before starting Entresto.

✔️ Storage:

• Keep below 30°C in a dry place.
• Protect from moisture.
• Keep out of reach of children.