Page 100 - pharma 1 theoretical updated MNU_Neat

Clinical pharmacy 2024/2025 Level 3 Pharm D Pharmacology 1 (PO 502)

2- Angiotensin Receptor-Neprilysin Inhibitor (ARNi)

➢ Sacubitril/Valsartan

➢ Angiotensin Receptor-Neprilysin Inhibitor (ARNi) has been specifically designed to
treat heart failure. It consists of 2 components that work together: an angiotensin II
receptor blocker and a neprilysin inhibitor.

➢ Studies have shown that ARNi may improve the length of life and reduce the risk of
being re-hospitalized for heart failure.

➢ ARNi is currently used for the treatment of patients with heart failure with reduced

ejection fraction, which means reduced function of the main pumping chamber.

➢ MOA
➢ What they do: The two active substances, sacubitril and valsartan, work in different

ways.
 Valsartan blocks the action of a hormone from the kidney called angiotensin II,
which can be harmful in patients with heart failure. This effect stops the hormone’s

harmful effects on the heart, and it allows blood vessels to dilate or widen.

 Sacubitril blocks the breakdown of natriuretic peptides produced in the body.

 Natriuretic peptides cause sodium and water to pass into the urine. This effect
reduces the work on the heart and reduces blood pressure. The combined effect of
the two medicines reduces the strain of the failing heart.

➢ What are the expected benefits?

➢ Sacubitril/valsartan has been shown to help people to live longer, reduce
hospitalizations for decompensated heart failure, and improve symptoms and

quality of life.

➢ Side effects:
➢ ARNI treatment is well tolerated.

➢ Mild dizziness may occur especially at the beginning of treatment.
➢ Low blood pressure can also occur.
➢ This side effect normally disappears within 14 days. If not, your provider may advise

you to take a smaller dose of ARNi.

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