(Updated on: 28/05/2020)
Atherosclerotic lesions of the main arteries are the main cause of cardiovascular diseases, leading to a high mortality rate worldwide. Entresto belongs to the pharmacological group of drugs intended for the treatment and prevention of CVD of all age categories.
What is Entresto?
Entersto is a combined drug based on two main active components Valsartan and Sacubitril (Valsartan + Sacubitril), an aqueous (hydrate) compound of sodium salts.
Yuperio is another brand of vasodilator promoted by Novartis. Its composition and antigipertenzivnoe effect on the body similar to Interest.
As a result, in patients taking Entresto, the brain natriuretic hormone (NT - pro-BNP), which plays an important role in the diagnosis of SSN, decreased by 45%. Enalapril subjects gave out only 25% of the indicator.
These indicators are confirmed by the research of American scientist Scott Solomon from Brigham hospital in Boston. Analysis of more than eight and a half thousand medical records of patients with SSN, with the inclusion of Entresto in General therapy. Statistics confirmed that on average, the life of "severe" patients increased by 2-3 years, and in patients with "moderate" heart diseases when treated with Entresto (Sacubitril + Valsartan), well-being significantly improved.
Instructions for use Entresto (Securitel + Valsartan)
In such a serious progressive disease like heart failure ( Congestive Heart Failure (CHF)), structural and functional disorders of the heart develop. As a result, the ventricles begin to fill poorly with blood or throw it out. The course of sleep can deteriorate dramatically, which is why the patient can not do without urgent hospitalization. The drug Entresto with a pair of active components Sacubitril + Valsartan is used for this category of patients. It helps to significantly reduce the number of deaths among patients with class 2-4 CH, in which there is a reduced ejection fraction.
Entresto operates on a completely different principle in comparison with ACE inhibitors. Sacubitril and Valsartan block the action of angiotensin-neprilysin receptors. This increases the concentration of natriuretics and several vasoactive, i.e. vasodilating peptides. This allows you to significantly reduce the load on the background of the CH.
Oral use of the combination of Sacubitril + Valsartan is accompanied by the achievement of maximum peak concentrations in the blood after 1 hour and 1.5 hours, respectively. Sacubitril has a bioavailability higher than 60%, Valsartan-23%. It takes 3 days to reach the equilibrium concentration of active substances. Both components and their metabolites actively bind to plasma proteins (almost 97%). About 68% of the substance Sacubitril is eliminated by the kidneys, 37% - through the intestines. Valsartan is mainly excreted in the feces, and a smaller part (less than 13%) — in the urine.
You can buy Entresto in tablet form. The exact price depends on the preferred dosage and manufacturer (European or Indian company).
Indications and contraindications:
They can not recommend buying Sacubitril + Valsartan to patients:
- With an allergic predisposition to the components of the drug.
- Receiving ACE inhibitors (including Entresto not apply within 36 h after the abolition of these inhibitors).
- Who in the past, during treatment with ACE inhibitors, ARA II encountered angioedema.
- Taking aliskiren, suffering from diabetes mellitus or moderate, severe kidney dysfunction.
- With biliary cirrhosis, cholestasis.
- Who is less than 18 years old.
- Pregnant and breast-feeding women.
- Taking medicines based on ARA II.
The decision to buy Entresto (Sacubitril + Valsartan) should be based only on medical advice. The cost of self-medication may be too high.
Application methods and dosage regimen
A recommendation to buy Entresto (Sacubitril + Valsartan) can only be given by a doctor who is familiar with the patient's medical history and the results of clinical tests. ACE inhibitor therapy should be discontinued. Treatment means Entresto becomes possible only after 36 hours afterward.
Therapy usually begins with taking 1 tablet (contains sacubitril in the amount of 49 mg and Valsartan — 51 mg, which is equivalent to 100 mg) twice a day. If necessary, on the 2-4 week of treatment, the dose can be doubled to 200 mg twice a day. Use the drug should be about 1 month. Depending on the complexity of the clinical case, the duration of the course may be extended.
Dosage 50 mg (Sacubitril 24 mg and Valsartan 26 mg) is prescribed in the case of:
- Previously not taken ACE inhibitors, or the use of these drugs in small doses.
- Severe renal or liver failure.
To buy Entresto, is to place an order on this website. Our consultants will answer all your questions about the drug and the conditions for obtaining it. The delivery price depends on how quickly you want to get the medicine.
According to the international drug classification system (ATX), the drug is a Sartan of AT1 - fibers of vascular structures responsible for the perception of signals, while simultaneously suppressing angiotensin II-dependent release of the adrenal cortex hormone necessary for the control of water-electrolyte balance and hemodynamics. As a result, the human immune system is inhibited, which contributes to the narrowing of the vascular lumen, the growth of body tissues by cell division (proliferation), detains fluid and sodium in the kidneys, and worsens heart failure.
In the gastrointestinal tract, a chemical reaction of active compounds occurs after using the tablet. The main components disintegrate, resulting in a new compound. After 30-40 minutes, the metabolite is maximally concentrated in the blood plasma. Food and medication intake do not affect the clinical indicators of the latter. The time of admission Entersto also not related to food.
Manufacturer Entresto (Sacubitril + Valsartan), is a multinational pharmaceutical company, one of the leaders in the production of original prescription medicines.
The drug is available in the form of oval-shaped pills, convex on both sides. They have a film coating of white and lilac shades with a bevel of the end edge. There is no dividing line. In the center section, the core has a milky or cream color. There is a double-sided engraving on the surface ("LZ" and "NVR").
The concentration of the main components, - 50 mg, 100 mg, 200 mg. The plate consists of 14 pills.
Method of use and dosage
Tablets can be taken with food twice a day.
Important! Start the course "Entresto" minimum doses. An increase in the daily allowance is allowed only once a month.
Pay attention to the portability of Entresto. In the absence of pronounced side effects, the target intake is increased once every 2 to 4 weeks (until reaching 200 mg).
The duration of the initial course is 4 weeks. Correction of treatment is possible only according to the indications of a cardiologist.
Important! To avoid antibiotic edema, the drug can be taken 36 hours after the withdrawal of angiotensin-converting enzymes (a complex of inhibitors for correcting arterial hypertension).
If signs of intolerance to the active elements are diagnosed, which are expressed in failures in the kidneys, a sharp decrease in blood PRESSURE, an increased content of potassium in the liquid part of the blood (hyperkalemia), an adjustment of the dosage or complete rejection of the drug is considered.
Entersto therapy is performed with caution and under the strict supervision of cardiologists in a group of patients with a history of concomitant complications.
- Patients with mild or moderate renal dysfunction do not need to reduce the dosage of the drug;
- With severe forms, daily dosage is limited to 50 mg;
- Patients with mild hepatic disorders (hepatitis A), the dosage is left unchanged;
- With pathologies of class " B " (according to the estimated classification of severity of Child-Pugh cirrhosis), a single dose is 50 mg In hepatitis "C" Entersto contraindicated.
For elderly patients, the daily portion remains standard (according to the instructions). But the duration of exposure to harmful factors on the body was noted by an average of 25-40 %, than in younger examined victims of SSN.
For vital indications, the medication is prescribed to children under 18 years of age and daily intake is calculated individually.
Ethnicity and gender do not affect Entresto treatment. Although there is evidence that African-Americans have more risks of side effects.
10 Signs of a Heart Condition
Symptoms of a heart attack include pain behind the sternum, abnormal heart rate, high blood pressure, severe shortness of breath, dizziness, sweating, and sometimes even loss of consciousness. But there are some signs of heart disease that begin to show up a few months or even years before a heart attack.
- Pain. It occurs not only in the chest but also in the upper part of the abdomen or neck, gives in the shoulder, arm, back, jaw. It may occur abruptly or repeat from day to day for weeks. It is often confused with dental, muscle pain, heartburn, intercostal neuralgia, and nerve pinching. It is easy to check: if when taking nitroglycerin, painful manifestations are noticeably relieved, it means that they are associated with heart disease.
- Lack of air. Even slight shortness of breath should be a cause for alarm: this symptom accompanies heart disease in 90% of cases. And without physical exertion, in a supine position. A few days before the attack, a person often becomes more comfortable to sleep sitting down.
- Excessive fatigue. Fatigue can be associated with increased loads, stress, but these symptoms are also possible with the development of heart failure. If there is indeed a violation of the heart, the person feels more and more broken over time.
- Edema. If the heart is not working at full capacity, the blood does not have time to remove all the fluid, there is edema. They are easy to spot by their rings and shoes.
- Rapid heartbeat. If the increase in heart rate is frequent and prolonged, we can talk about serious cardiac disorders.
- Snoring and impaired breathing during sleep. All this triples the risk of developing a heart attack within 5 years.
- Sudden dizziness or loss of balance. In heart diseases, they can signal vascular pathology, heart failure.
- Fainting. A serious reason to visit a cardiologist.
- Periodontitis and gingivitis. Inflammation and bleeding of the gums can also be associated with heart disease: with vascular and heart diseases, blood supply worsens and small arteries begin to suffer first.
- Sexual problems. 65% of men who were diagnosed with ischemia had erection problems for several years. This is also due to the deterioration of blood supply due to vascular pathologies.
Therapy "Entersto" contraindicated in the following cases:
- Hypersensitivity to one or more components of the drug (to avoid rapid development of local edema of the mucous membranes, skin, and subcutaneous tissue).
- Allergic reactions (Quincke's edema), in the anamnesis after previous treatment with drugs to reduce arterial hypertension.
- Simultaneous, or withdrawal period of fewer than 36 hours of angiotensin-converting enzyme.
- Moderate or severe renal failure with joint treatment with antidiabetic agents.
- Severe liver damage (hepatitis "C", cirrhosis, and bile stasis in cholestasis).
- Planning pregnancy, II-III trimester (substances penetrate to the fetus through the placenta), and the period of breastfeeding.
- Children under the age of 18.
Taking into account the risk factor from Entresto treatment will protect you from undesirable side effects.
- Severe degree of nephrological diseases (bilateral narrowing of the lumen of the renal vessels, a decrease in blood circulation, causing unstable end-diastolic pressure, taking medications that increase the content of potassium in the liquid component of the blood;
- Reflection in the history of cases of angioedema;
- During asynchronous reception Entersto with potent drugs aimed at lowering cholesterol;
- Men's use of drugs to improve their erections (erectile function);
For any of the listed items, you need to consult a cardiologist!
Pharmacological indicators of the drug and concomitant diseases recorded in the history of "cores" suggest some side effects.
- A sudden sharp decrease in blood pressure, which can lead to fainting or pre-fainting States. Orthostatic collapse from insufficient blood flow to the brain, associated with a change in the position of the trunk (when lifting or taking a sitting position);
- From the digestive tract, there is often a violation of metabolic processes associated with an increase or decrease in the accumulation of potassium in the blood, nausea, vomiting, diarrhea. Rarely-acute pancreatitis (inflammation of the pancreas);
- Dermatology: skin allergic manifestations (urticaria, pruritus, erythema multiforme, exfoliative Ritter dermatitis in newborns, dermatitis);
- Hearing impairment, "laying" of the ears associated with damage to the hearing organs (vertigo, partial or complete destruction of the receptors responsible for the perception of sounds);
- Failures of the respiratory system, in the complex of organs between the pleural cavities (lat. Mediastinum), dry coughing, lack of oxygen;
- From the immune system, - anaphylactic (for the first type) and anaphylactoid reactions that can lead to death;
- Nephrotic complications, inflammation of the urinary tract. It may be difficult to urinate;
- Swelling of the face and extremities;
- An imbalance of sensitivity associated with sudden tingling, burning and "goosebumps" in the extremities (paresthesia);
- Asthenic syndrome (weakness, fatigue);
- Panic attacks associated with a sense of imminent death.
Entresto (Securitel + Valsartan) can often be the cause:
- A marked decrease in blood PRESSURE;
- Orthostatic hypotension.
- Loose stool;
- Renal dysfunction;
- Increased fatigue;
Practice shows that 2 to 3 weeks after the start of the course, unpleasant symptoms disappear. But, in any case, you must inform your cardiologist about your condition.
In most cases, the excess dose of medications does not hurt the body. In some cases, you may experience dizziness, tinnitus, blurred visual images, nausea, vomiting, diarrhea, urinary retention, and decreased blood PRESSURE. Among the symptoms of poisoning can be noted hypovolemia (inadequate end-diastolic pressure), dehydration, blood thickening, arrhythmia. These indicators can lead to thrombosis, confusion, drug-induced delirium, and apathy.
To avoid the consequences, you should do gastric lavage.
In critical situations of a sharp drop in blood pressure, urgent measures are taken to maintain the patient's cardiovascular activity.
If you miss the time of taking the pill, you must drink the next portion at the appropriate time. Doubling a single dose is strictly contraindicated.
During the course Entresto avoid sudden climbs out of bed. Get up slowly and gradually to avoid dizziness and falling.
The decrease in blood pressure can affect the ability of the concentration to decrease psychomotor reactions and concentration of attention, therefore from driving motor vehicles during the period of healing Interest, should be avoided.
The effect of alcohol does not significantly affect the metabolism of active substances in the body. But, during therapy, its use is not desirable.
Entersto and other drugs
Before you buy Entersto , you must inform your doctor about taking other medicines. Especially if you take anti-diabetic, diuretic, hypotensive (which includes lithium and potassium), or anti-inflammatory drugs (Ibuprofen, Diclofenac, Aspirin, Indomethacin, etc.).
How to purchase?
You can not buy Entresto without a prescription, because it belongs to powerful medicines. It is prescribed by a cardiologist for vital reasons.