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Sacubitril / Valsartan Dosage

Applies to the following strength(s): 24 mg-26 mg ; 97 mg-103 mg ; 49 mg-51 mg

The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.

Usual Adult Dose for:

Additional dosage information:

Usual Adult Dose for Congestive Heart Failure

Initial dose: Sacubitril 49 mg-Valsartan 51 mg orally twice a day

Maintenance dose: Sacubitril 97 mg-Valsartan 103 mg orally twice a day

Comments:
-Increase to the target maintenance dose (sacubitril 97 mg-valsartan 103 mg twice daily) after 2 to 4 weeks, as tolerated.
-A starting dose of sacubitril 24 mg-valsartan 26 mg twice a day is recommended for patients not currently taking an angiotensin-converting enzyme (ACE) inhibitor or an angiotensin receptor blocker (ARB) and for patients previously taking low doses of these agents. Double the dose every 2 to 4 weeks to the target maintenance dose (sacubitril 97 mg-valsartan 103 mg twice daily), as tolerated.

Use: To reduce the risk of cardiovascular death and hospitalization for heart failure in patients with chronic New York Heart Association (NYHA) Class II to IV heart failure and reduced ejection fraction; usually administered in conjunction with other heart failure therapies or in place of an ACE inhibitor or other ARB.

Renal Dose Adjustments

Mild to moderate renal dysfunction: No adjustment recommended

Severe renal dysfunction (estimated GFR less than 30 mL/min/1.73 m2): Sacubitril 24 mg-Valsartan 26 mg orally twice a day; double dose every 2 to 4 weeks to target maintenance dose (sacubitril 97 mg-valsartan 103 mg twice daily), as tolerated.

Liver Dose Adjustments

Mild liver dysfunction: No adjustment recommended

Moderate liver dysfunction (Child-Pugh B): Sacubitril 24 mg-Valsartan 26 mg orally twice a day; double dose every 2 to 4 weeks to target maintenance dose (sacubitril 97 mg-valsartan 103 mg twice daily), as tolerated.

Severe liver dysfunction: Not recommended

Precautions

US BOXED WARNING:
-FETAL TOXICITY: If pregnancy is detected, discontinue this drug as soon as possible. Drugs that act directly on the renin-angiotensin system (RAS) can cause injury and death to the developing fetus.

Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Monitoring:
-Monitor serum potassium periodically, especially in patients with severe renal impairment, diabetes, hypoaldosteronism, or a high potassium diet.
-Closely monitor serum creatinine.

Patient advice:
-Females of childbearing age should be informed of the consequences of exposure to this drug during pregnancy; ask these patients to report pregnancies as soon as possible.
-Advise patients to discontinue use of their previous angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB). Advise patients to allow a 36 hour wash-out period if switching from or to an ACE inhibitor.

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