This is an automatically translated article.
Article by Pharmacist Huynh Xuan Loc - Faculty of Pharmacy - Vinmec Central Park International General Hospital
The drug combination sacubitril and valsartan, commonly known as Uprio, is a drug effective in the treatment of symptomatic heart failure in patients with systolic dysfunction. Sacubitril is a prodrug that inhibits the enzyme neprilysin, which helps to dilate blood vessels and increase sodium secretion, while valsartan is an angiotensin II receptor blocker for vasodilatation and blood pressure reduction.
When combined with the above 2 active ingredients in appropriate doses, the drug has been shown to reduce mortality from cardiovascular disease and reduce hospitalization for heart failure.
1. Precautions when using valsartan/sacubitrile combination tablets
The combination valsartan/sacubitril (Uperio) is a prescription drug and must be considered by a specialist depending on the stage of the disease, so patients should not self-medicate in all cases.
Do not use the drug if the patient has a history of allergy to sacubitril, valsartan or any of its ingredients (cellulose, crospovidone, magnesium sterate ...).
The patient must inform the doctor if he or she has ever experienced angioedema side effects (swelling of the face, lips, tongue, throat, difficulty breathing) due to the use of receptor blockers. angiotensin (ACEi, eg enalapril, lisinopril, ramipipril ...) or angiotensin II receptor blocker (ARB, eg valsartan, telmisartan, irbesartan). The use of Upperio should be avoided in these cases. In addition, the patient should also inform the treating doctor about the drugs being used, especially ACE inhibitors because of the potential for increased risk of side effects when taking these drugs with Uperio. In this case, the patient needs to stop taking this ACE inhibitor for 36 hours after the last dose and then start taking Upio as prescribed by the treating doctor. In addition, Uperio should not be used concurrently with drugs containing the active ingredient aliskiren (a direct renin inhibitor) in patients with type 2 diabetes mellitus or patients with impaired renal function. Patients with severe liver failure, biliary cirrhosis or cholestasis, and end-stage renal failure are also not recommended to use Uperio.
Uperio is not intended for use by pregnant women, so inform your doctor if you are pregnant, expecting a baby or suspect that you may be pregnant. In these cases, the doctor will usually ask to stop the drug to avoid affecting the pregnancy and will consider choosing other drugs to replace Upio. Similarly, Uperio is not recommended in women who are breastfeeding, so patients should discuss the benefits and risks of treatment with their doctor and breast-feeding for advice and decision-making. Fit.
Uperio is not for use in children (under 18 years old) because there are no research data to prove the safety and effectiveness of the drug in this population.
The drug can cause side effects such as dizziness or fatigue, so care should be taken when the patient has to drive, operate machinery or perform tasks that require special attention at first. use medicine.
Thuốc sacubitril có thể gây chóng mặt và mệt mỏi cho người uống
Use the right medicine according to the dose and instructions of the treating doctor or consulting pharmacist. Usually the drug will be taken twice a day, one dose in the morning and one in the evening. The dose will need to be adjusted by the doctor (increase, decrease or stop if necessary) after a period of use depending on the response to the drug and the condition of the disease. That's why it's so important to have regular check-ups with your doctor.
The tablet is swallowed whole with a glass of water with or without food. Patients should not split or crush the tablet because it may affect the quality of the drug and treatment.
The drug is taken every day during the treatment period, so patients need to avoid forgetting the medicine to ensure effective treatment. If you miss a dose, take your next dose at the usual time. Do not take a double, triple ... dose to make up for a missed dose because it can cause serious and life-threatening hypotension.
If you accidentally take an overdose of Uperio or someone else takes the wrong medicine, you should immediately contact your doctor for instructions on monitoring and appropriate treatment. If symptoms of dizziness or fainting appear worse after taking the drug, the patient should lie down and be taken immediately to a medical facility for timely treatment.
Patients are also not allowed to stop taking the drug on their own because this can make heart failure worse. In all cases, the patient needs to inform the doctor about any changes or unusual symptoms when taking the drug for appropriate and timely treatment.
Keep the medicine in its original blister and packaging to protect it from moisture from the outside environment. Do not use medicine that has expired or is damaged or broken.
2. Side effects of sacubitril/valsartan combination tablets
Like other drugs, the sacubitril/valsartan (Uperio) combination tablet can also cause harmful side effects.
The most notable side effect of Uperio is angioedema which manifests as swelling of the face, lips, tongue, and throat and can lead to difficulty breathing or swallowing. When experiencing this side effect, the patient should stop taking the drug and immediately contact the treating doctor or go to the nearest medical facility for timely treatment.
The drug may also worsen renal function or increase the risk of hypotension in patients with renal impairment. The risk of impaired renal function is also increased if the patient is dehydrated or is taking non-steroidal anti-inflammatory drugs concurrently. Therefore, patients in these cases need periodic tests to evaluate kidney function.
Other common side effects include hypotension, hyperkalemia or impaired renal function. Accordingly, the doctor may ask the patient to periodically perform tests to screen for these changes. In addition, symptoms such as dry cough, dizziness, diarrhea, fatigue, drowsiness, headache, nausea, stomach upset, low blood sugar or even fainting can also occur with the drug.
Patients should note the above side effects or any other unusual changes in the body during the time of taking the drug to notify the doctor. If symptoms worsen or persist, affecting the patient's quality of life, it is necessary to notify the doctor immediately for appropriate treatment.
Người bệnh có thể gặp tình trạng phù mặt, môi, lưỡi khi dùng thuốc sacubitril
3. Drug interactions to be aware of with sacubitril/valsartan combination tablets
The most important drug interaction with Uperio is with ACE inhibitors due to the increased risk of drug toxicity. You should notify your doctor and stop taking these drugs 36 hours before starting treatment with Uperio.
Other drugs that should also be considered when taking Uperio include:
Other antihypertensive or heart failure medications such as ARBs or aliskiren; Drugs that help lower blood cholesterol statin group; Medicines for pulmonary hypertension or erectile dysfunction such as sildenafil; Medicines that add potassium or increase blood potassium such as potassium tablets, potassium-sparing diuretics (spironolactone, eplerenone) or heparin; Non-steroidal anti-inflammatory medicines (NSAIDs) due to the risk of worsening renal function; Psychiatric drugs such as lithium; diuretics such as furosemide; Medicines for angina such as nitroglycerine; Antibiotics of the rifamycin group, antiviral such as ritonavir; Anti-rejection drugs such as ciclosporin. Diabetes medications such as metformin. If the patient is taking any of the drugs listed above, the patient should inform the treating physician so that an appropriate decision can be made to ensure the safety and effectiveness of treatment.
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