Neprilysin inhibitor
- Natriuretic peptides are not degraded
- Natriuresis, vasodilation and ↓ cardiac remodeling
- Heart failure benefit
- ↑ bradykinin → angioedema risk
- Never combine with an ACE inhibitor
- ↑ angiotensin II (also a neprilysin substrate) → paired with an ARB
Drugs with this mechanism (1)
- Sacubitril — Neprilysin inhibitor; paired with valsartan (Entresto) for heart failure.
Self-check
- Why pair neprilysin inhibition with an ARB?
Angiotensin II also rises. - Which drug class must not be combined with a neprilysin inhibitor?
ACE inhibitors.
All mechanisms · Open Neprilysin inhibitor in the interactive console ↗