Sacubitril/Valsartan Sodium Tablets (Entresto) is the first angiotensin receptor-neprilysin inhibitor (ARNI), demonstrating breakthrough efficacy in the field of heart failure treatment. Fully understanding its side effect profile, being alert to severe adverse reactions, and mastering the key points of standardized medication use are crucial for achieving individualized treatment.
What Are the Side Effects of Sacubitril/Valsartan Sodium Tablets (Entresto)?
Cardiovascular System Reactions
Hypotension (incidence rate: 8.8%), which is more common during the initial treatment and dose escalation stages.
Elderly patients and those with pre-existing low blood pressure have a relatively higher risk.
Metabolic Disorders
Hyperkalemia (incidence rate: 3.9%).
Renal dysfunction (incidence rate: 2.4%).
Reactions in Other Systems
Cough and fatigue.
Abnormal laboratory test results (such as elevated AST/ALT, increased BUN, etc.).
Severe Adverse Reactions of Sacubitril/Valsartan Sodium Tablets (Entresto)
Angioedema (incidence rate: 0.2%)
It may present with symptoms such as swelling of the tongue, glottis, and larynx, and there is a risk of airway obstruction.
Immediate drug discontinuation and emergency treatments such as epinephrine injection and airway management are required.
Special attention should be paid to intestinal angioedema accompanied by abdominal pain, nausea, vomiting, and diarrhea.
Re-administration is prohibited after angioedema subsides.
Renal Impairment and Renal Failure
The incidence rate of renal dysfunction is 2.4%.
The incidence rate of renal failure is 0.6%.
Close monitoring of serum creatinine and eGFR (estimated glomerular filtration rate) is necessary.
Anaphylactic Shock and Consciousness Disorders
Shock (incidence rate: <0.1%), syncope (incidence rate: 0.2%), and loss of consciousness (incidence rate: <0.1%).
Hematological Abnormalities
Agranulocytosis, leukopenia (incidence rate: <0.1%), and thrombocytopenia.
Precautions for Sacubitril/Valsartan Sodium Tablets (Entresto)
Control of Medication Switching Time Window
Patients using angiotensin-converting enzyme inhibitors must discontinue the drug at least 36 hours before starting Entresto administration.
After the end of treatment with Sacubitril/Valsartan Sodium Tablets, a 36-hour waiting period is required before starting angiotensin-converting enzyme inhibitor treatment.
Principles of Dose Adjustment
Initial dose: 50mg twice daily (for adults with chronic heart failure).
Dose escalation interval: 2-4 weeks.
Maximum dose: 200mg twice daily.
Dose adjustment must comprehensively consider blood pressure (systolic blood pressure ≥95mmHg), blood potassium (≤5.4mEq/L), and renal function indicators.
Key Points of Medication Monitoring
Regularly monitor blood pressure, serum potassium, and renal function.
Conduct regular liver function tests.
Observe symptoms of dehydration and provide fluid replacement therapy if necessary.
Specifications for Using Special Dosage Forms
Granular tablets must be removed from the capsule container before use.
Administration of the entire capsule is strictly prohibited.
