Angiotensin receptor-neprilysin inhibitor (ARNI)
- Sacubitril/valsartan = ARNI
- Preferred RAAS-pathway drug for many HFrEF pts
- ↓ HF hospitalization + CV death
- Also lowers BP
- Hyperkalemia, renal dysfunction, hypotension
- Angioedema risk; never combine with ACEi
- allow 36 h after ACE inhibitor
Class at a glance
- Sacubitril/valsartan = ARNI
Clinical role
- Preferred RAAS-pathway drug for many HFrEF pts
Practical pearls
- ↓ HF hospitalization + CV death
- Also lowers BP
Safety / monitoring
- Hyperkalemia, renal dysfunction, hypotension
- Angioedema risk; never combine with ACEi
- allow 36 h after ACE inhibitor
Self-check
- Which partner must never be combined with an ARNI?
ACE inhibitors. - How long after an ACE inhibitor should ARNI initiation wait?
36 h.
Drugs in this class (3)
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