Arnis 49 mg+51 mg (Tablet)
Unit Price: ৳ 70.00 (1 x 10: ৳ 700.00)
Strip Price: ৳ 700.00
Medicine Details
| Category | Details |
|---|---|
| Generic | Sacubitril valsartan |
| Company | Eskayef pharmaceuticals ltd |
| Also available as |
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
- Administered in conjunction with other heart failure therapies, in place of an angiotensin-converting enzyme inhibitor (ACEi) or other ARB
Pharmacology
- Contains a neprilysin inhibitor, sacubitril, and an angiotensin receptor blocker, valsartan
- Inhibits neprilysin (neutral endopeptidase; NEP) via LBQ657, the active metabolite of the prodrug sacubitril, and blocks the angiotensin II type-1 (AT1 ) receptor via valsartan
- Increased levels of peptides that are degraded by neprilysin, such as natriuretic peptides, by LBQ657, and the simultaneous inhibition of the effects of angiotensin II by valsartan
Dosage & Administration
- Recommended starting dose for adult heart failure is 49/51 mg orally twice daily
- Reduce the starting dose to 24/26 mg twice daily for specific patient groups
- Refer to Table 1 for the recommended dose for pediatric patients aged one year and older
- 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 the risk of renal impairment
- Increased risk of lithium toxicity when used with lithium
Contraindications
- Contraindicated in patients with hypersensitivity to any component
- In patients with a history of angioedema related to previous ACE inhibitor or ARB therapy
- Do not administer within 36 hours of switching from or to an ACE inhibitor
Side Effects
- Angioedema
- Hypotension
- Impaired renal function
- Hyperkalemia
- Cough
- Dizziness
Pregnancy & Lactation
- No safety and effectiveness 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
- No dose adjustment required in patients with mild to moderate renal impairment
- Severe renal impairment requires a recommended starting dose of 24/26 mg twice daily
Precautions & Warnings
- May cause angioedema and must not be used in patients with a known history of angioedema
- Lowers blood pressure and may cause symptomatic hypotension
- Closely monitor serum creatinine
- 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
- Severe renal impairment requires a starting dose of 24/26 mg twice daily
- Moderate hepatic impairment requires a starting dose of 24/26 mg twice daily
- Not recommended for use in patients with severe hepatic impairment
Overdose Effects
- Limited data available with regard to overdosage
- Hypotension is the most likely result of overdosage
- Symptomatic treatment should be provided
- Unlikely to be removed by hemodialysis because of high protein binding
Storage Conditions
- Keep in a dry place and store below 30°C
- Protect from moisture
- Keep out of the reach of children