Nepitan 24 mg+26 mg (Tablet)

Unit Price: ৳ 45.00 (1 x 10: ৳ 450.00)
Strip Price: ৳ 450.00

Medicine Details

Indications

  • To reduce the risk of cardiovascular death and hospitalization for heart failure in patients with chronic heart failure (NYHA Class ll-IV) and reduced ejection fraction
  • For the treatment of symptomatic heart failure with systemic left ventricular systolic dysfunction in pediatric patients aged one year and older
  • Usual administration in conjunction with other heart failure therapies
  • Replacement of an angiotensin-converting enzyme inhibitor (ACEi) or other ARB

Pharmacology

  • Contains neprilysin inhibitor, sacubitril, and angiotensin receptor blocker, valsartan
  • Inhibits neprilysin via LBQ657, the active metabolite of sacubitril
  • Blocks the angiotensin II type-1 (AT1 ) receptor via valsartan
  • Effects attributed to increased levels of peptides degraded by neprilysin and simultaneous inhibition of angiotensin II effects

Dosage & Administration

  • Recommended starting dose for adult heart failure: 49/51 mg orally twice daily
  • Double the dose after 2 to 4 weeks to the target maintenance dose of 97/103 mg twice daily
  • Pediatric dose adjustment every 2 weeks, as tolerated by the patient
  • Recommended dose titration for pediatric patients based on weight categories

Interaction

  • Should not be used with an ACEi, aliskiren in patients with diabetes, and use with an ARB should be avoided
  • Potassium-sparing diuretics may increase serum potassium level
  • NSAIDs may increase risk of renal impairment
  • Increased risk of lithium toxicity when used with lithium

Contraindications

  • Hypersensitivity to any component
  • History of angioedema related to previous ACE inhibitor or ARB therapy
  • Concomitant use of ACE inhibitors, aliskiren in patients with diabetes

Side Effects

  • Angioedema
  • Hypotension
  • Impaired renal function
  • Hyperkalemia
  • Cough
  • Dizziness

Pregnancy & Lactation

  • Safety and effectiveness not established in pediatric patients less than 1 year of age
  • No relevant pharmacokinetic differences observed in elderly patients
  • No dose adjustment required in patients with mild hepatic impairment
  • Not recommended in patients with severe hepatic impairment
  • Starting dose adjustment required in patients with renal impairment

Precautions & Warnings

  • May cause angioedema
  • May lower blood pressure and cause symptomatic hypotension
  • Monitor serum creatinine and renal function
  • Monitor serum potassium periodically and treat appropriately

Use in Special Populations

  • Safety and effectiveness not established in pediatric patients
  • No relevant pharmacokinetic differences observed in elderly patients
  • Dosage adjustment required in patients with severe renal impairment
  • Dosage adjustment required in patients with moderate hepatic impairment
  • Not recommended in patients with severe hepatic impairment

Overdose Effects

  • Limited data available
  • Hypotension is the most likely result of overdosage
  • Symptomatic treatment should be provided

Storage Conditions

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

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