Sacubitril
Sacubitril is the neprilysin-blocking half of a heart failure tablet taken with valsartan; the shop lists it as generic Entresto in 97/103mg tablets.
Sacubitril and its partner
Sacubitril is never sold on its own. It is paired with valsartan in a single tablet, and the pair is known as an ARNI (angiotensin receptor-neprilysin inhibitor). The tablet is for adults with chronic heart failure and a reduced ejection fraction, which means the heart's main pumping chamber sends out less blood with each beat than it should.
Picture a heart that already pumps too weakly. It releases natriuretic peptides, hormones that relax the blood vessels and tell the kidneys to clear salt and water, but the enzyme neprilysin keeps breaking them down. Sacubitril blocks that enzyme, so their help lasts longer. Valsartan, in the same tablet, blocks angiotensin II, a hormone that does the opposite by tightening vessels and holding on to fluid. The body turns sacubitril into its active form after the tablet is swallowed.
What the shop lists
Entresto is the only listing: generic sacubitril with valsartan, in 97/103mg tablets, for chronic heart failure with reduced ejection fraction.
That is the highest strength. People normally begin on a smaller tablet and work up over a few weeks, so 97/103mg comes later in treatment. It is taken twice a day, every day, even once breathing and swollen ankles have improved, because the tablet keeps heart failure under control and does not cure it.
What it does to you
Low blood pressure is the everyday effect. It shows up as light-headedness on standing, mostly in the first weeks, and getting up slowly helps. Dizziness, cough, raised potassium in the blood and a dip in kidney function are the other usual findings, which is why blood tests are a routine part of taking it. Sweating heavily, vomiting or diarrhoea can drop blood pressure further.
Angioedema, a swelling of the face, lips, tongue or throat, is rare but needs urgent treatment, and the risk is higher in anyone who has had it before.
Combinations to avoid
An ACE inhibitor such as ramipril, lisinopril or enalapril must never be taken alongside it, because the mix sharply raises the chance of angioedema. The ACE inhibitor has to be stopped at least 36 hours before the first sacubitril tablet. Another angiotensin blocker, such as losartan, duplicates the valsartan already in the tablet.
Potassium supplements, potassium-based salt substitutes and some diuretics, including spironolactone, can push potassium too high. Anti-inflammatory painkillers such as ibuprofen and naproxen put extra strain on the kidneys. Pregnancy rules the tablet out altogether, because valsartan can harm an unborn baby.
Sources
- Sacubitril and Valsartan: MedlinePlus Drug Information — MedlinePlus / U.S. National Library of Medicine
- Chronic heart failure in adults: diagnosis and management | Guidance | NICE — National Institute for Health and Care Excellence
Is Sacubitril available to order in Hong Kong?
Sacubitril can be ordered online with delivery to Hong Kong. The page lists generic Entresto tablets in 97/103mg, a combination of sacubitril and valsartan. Payment is by Visa, Mastercard or American Express on a secure, encrypted payment page, or by Bitcoin or Ethereum.
How much does Sacubitril cost?
Entresto is priced per pack: its page lists every strength and pack size with the current price in HKD or your chosen currency.
Do I need a prescription to order Sacubitril?
PockDose does not ask you to upload a prescription when you order sacubitril. See the ordering FAQ for details.
What are the other names for sacubitril and valsartan?
Entresto and Vymada are brand names of sacubitril and valsartan. Here, sacubitril and valsartan can be bought online as generic Entresto. These are generics, not the original brand.
Is Entresto the same as sacubitril?
Sacubitril is one of Entresto's two ingredients, with valsartan as the other. Entresto is the brand name of the combined tablet, and the listing here is generic sacubitril with valsartan, so you buy the two together.
Can sacubitril be taken with lisinopril or ramipril?
No. Both are ACE inhibitors, and combining one with sacubitril greatly raises the risk of angioedema, a dangerous swelling of the face and throat. An ACE inhibitor has to be stopped at least 36 hours before the first sacubitril tablet.
Why does sacubitril make me dizzy?
It lowers blood pressure, and the drop is largest when you stand up quickly or when the body is short of fluid. Rising slowly, drinking enough and avoiding long spells in the heat usually keep dizziness manageable.
Can I take ibuprofen with sacubitril and valsartan?
It is best avoided. Ibuprofen and similar painkillers can reduce kidney function and raise potassium, both of which this tablet can do already. Paracetamol does not carry the same kidney risk.