Let's learn about this special medicine (Sacubitril; Valsartan) given for heart failure.

Do you also have difficulty breathing, feel like you're going to faint even with a little exertion? Or has your doctor told you that you have some kind of heart failure? If so, you may have been prescribed a medicine called Sacubitril; Valsartan (---‍; --) . It usually comes under the brand name `Entresto`. So, today we'll talk about this medicine, how to use it, and what to be careful about. Just like you would tell a friend.

What kind of medicine is this? Why is this being given?

Simply put, this `Sacubitril; Valsartan` is a combination of two medications. One is `Sacubitril` க்ய-஬ி-ட்ரில்),-க்ய-஬ி-ட்ரில் - க்ய-஬ி-ட்ரில்), this is a medicine belonging to the `(neprilysin inhibitor)` group. The other is `Valsartan` கா-தன்),-வலஸாட் -ஸாட்ரில் - க்ய-஬ி-ட்ரில்), this is a medicine belonging to the `(angiotensin II receptor blocker - ARB)` group. These two medications work together. This medicine is mainly given to people with heart failure . Heart failure is a condition in which the heart is unable to pump enough blood to the body. Think of it, the heart is like a water pump. If it is not working properly, it is as if water is not flowing throughout the body, and blood is not flowing throughout the body. That is when things like fatigue and shortness of breath come. So, what this medicine does is to help the heart's pumping ability and reduce the load on the heart. Sometimes doctors may use this medicine for other medical conditions as well. That is up to your doctor to decide.

What should I tell my doctor before starting this medication?

This is very important. Before you start taking this medicine `Sacubitril; Valsartan`, you should definitely tell your doctor or nurse about these things. Don't hide anything.

• Tell your doctor if you have diabetes ( Diabetes Mellitus) , especially if you are taking the medicine aliskiren.
• If you know that your blood potassium level is high .
• If you have any kidney disease .
• If you have any liver disease .
• If you have low blood pressure (`low blood pressure` ) .
• This is `Sacubitril; Valsartan`, or `(If you have had an allergic reaction to medicines called ACE inhibitors (e.g., enalapril, lisinopril), medicines called angiotensin II receptor blockers (ARBs) (e.g., losartan, telmisartan), any other medicine, food, food dyes, or preservatives .
• If you are pregnant, or trying to get pregnant . This is very important, we will talk about this later.
• If you are a breastfeeding mother .

Once you have these things in mind, your doctor can decide exactly whether or not this medication is right for you, and how to give it.

How do you use this medicine correctly?

When taking a medicine, the most important thing is to use it correctly. Otherwise, it won't work properly.

• How to take: This comes in pill form. It is to be taken by mouth. Try to take the prescribed dose, exactly as your doctor has prescribed, at the same time every day . That way, the medicine will work the same way.
• With or without food?: You can take this pill with or without food. However, some people may experience stomach upset if they take it without food. In that case, it is best to take it with food.
• Stopping: Continue using this medicine until your doctor tells you to. Do not stop suddenly. If you need to stop, talk to your doctor and follow his or her instructions.
• Can this medicine be given to children?: Yes, sometimes this medicine can be given to children as young as one year old for selected heart conditions. However, it definitely requires special care and medical supervision.
• What to do if you take too much: If you think you have taken too much of this medicine, or if you have accidentally taken too many pills, go to the nearest hospital emergency room or call a poison control center immediately. Don't waste time.
• Do not share: This is also something to remember. This medicine has been prescribed for you only, to treat your condition. Therefore, never give this medicine to your friends, relatives, or other family members, even if they say they have the same problem as you.

What do you do if you miss a medication appointment?

We sometimes forget to take our medicine. If that happens, don't worry.

• Take your medicine as soon as you remember.
• However, if it is almost time for your next dose when you remember, skip the missed dose and just take the next dose at the scheduled time.
• Never take a double dose to make up for a missed dose.Doing so may cause side effects.

What other medications should not be used with this medicine, or could cause side effects?

This is also a very important point. This medicine called `Sacubitril; Valsartan` can cause problems when taken with certain other medicines. That is, either the effectiveness of this medicine may be reduced, or it may be increased, or new side effects may occur.

Do not take `Sacubitril; Valsartan` together with these medications:

* If you have diabetes, with the medicine `(aliskiren)`.

* With medicines called `(Angiotensin-converting enzyme - ACE inhibitors)`. For example, medicines like `benazepril`, `captopril`, `enalapril`, `fosinopril`, `lisinopril`, `ramipril`. Even if you stop taking such a medicine for a few days, it is not a good idea to start `Sacubitril; Valsartan`. Talk to your doctor about it.

* With the medicine `(tranylcypromine)`.

The following medications may interact with `Sacubitril; Valsartan`. Therefore, tell your doctor about these as well:

• Other types of Angiotensin II receptor blockers (ARBs). Examples: azilsartan, candesartan, eprosartan, irbesartan, losartan, olmesartan, telmisartan, or valsartan (if you are taking valsartan separately in addition to the valsartan in this medicine).
• Medicines like `(celecoxib)`.
• `(lithium)` (a medicine given for mental illnesses).
• `(NSAIDs)` - These are medicines that are used to relieve pain and inflammation. Examples: `ibuprofen`, `naproxen`. These can often be purchased over the counter at pharmacies, so if you use them, mention them.
• Potassium-sparing diuretics. Examples: amiloride, spironolactone, triamterene.
• Potassium supplements or potassium-rich salt substitutes.

This list may not include all medications. Therefore, it is important to tell your doctor about all medications you are taking, including vitamins, herbal remedies, over-the-counter medications, and traditional medicines. Also, be honest with your doctor about any medications you are taking, including medications you smoke, alcohol, or other illegal drugs. These can affect how well this medication works.

What should I be especially careful about when taking this medicine?

Please pay attention to these points while using this medicine to ensure your safety and to get the maximum benefits from the medicine.

• Watch for symptoms: If your heart disease symptoms (such as shortness of breath, fatigue, swelling in your legs) do not improve after starting this medication, or if they seem to get worse, tell your doctor right away.
• Pregnancy (this is extremely important!):

Do not become pregnant while taking Sacubitril; Valsartan. This medicine can cause serious harm to an unborn baby, and may even be life-threatening. Therefore, if you are planning to become pregnant, or if you think you may be pregnant, stop taking this medicine immediately and tell your doctor. Your doctor will give you appropriate advice. Ask your doctor for more information.

• Drowsiness or dizziness: Some people may feel a little drowsy or dizzy when taking this medicine. Therefore, avoid driving, operating heavy machinery, or doing anything that requires concentration and alertness until you know exactly how this medicine affects you. Do not get up from a sitting position or sit down from a standing position suddenly. Be especially careful if you are elderly. Changing positions frequently can reduce the risk of dizziness and falls.
• Alcohol: Avoid alcohol as much as possible while taking this medication. Alcohol can interfere with the effectiveness of this medication and may increase side effects.
• Salt substitutes: Some salt substitutes contain potassium. You should be careful about your potassium levels while taking this medication, so do not use salt substitutes unless your doctor specifically tells you to.

What are the possible side effects of this medicine?

Like any medicine, Sacubitril; Valsartan can cause side effects in some people. Not everyone gets them, but it's good to be aware of them. If you get any of the following side effects, tell your doctor or hospital as soon as possible:

• Allergic reactions:
• Skin lesions, eczema-like, itching, hives.
• Swelling of the face, lips, tongue, or throat (this is very dangerous as it can cause difficulty breathing).
• High potassium levels in the blood:
• Feeling like chest pain.
• Heartbeat suddenly becomes rapid and irregular.
• Feeling of weakness and numbness in the muscles.
• Kidney injury:
• Feeling difficulty urinating.
• Passing less or more urine than usual.
• Change in urine color.
• Low blood pressure:
• Feeling dizzy, especially when standing up.
• Feeling faint, eyes turning blue.
• Feeling like you are going to fall while standing.
• Feeling unusually weak and tired.

The side effects listed below are usually not something you should worry about. But if they persist or bother you, tell your doctor:

• Cough: Some people may develop a dry cough when taking this medicine.

If you experience any unusual symptoms or side effects that are not listed here, talk to your doctor about them. Don't worry, most of these things can be managed.

How do you keep this medicine safe?

It is also very important to keep medicines safe.

• Keep it out of the reach of children and pets. This is common to all medicines.
• Store at room temperature (between 20 and 25 degrees Celsius, between 68 and 77 degrees Fahrenheit). Protect from excessive heat, light, and moisture. This means not storing in places like the bathroom.
• Keep the bottle or packet containing the medicine tightly closed.
• Do not use expired medicine. The expiration date is mentioned on the package.

How do you dispose of unused or expired medications?

• The best thing to do is to give the medication to a ``take-back program.'' Check with your pharmacy or the nearest police station to see if they have such programs.
• If that is not possible, check the medication label or packet to see if there are instructions on how to dispose of the medication in the trash or flush it down the toilet.
• If you are not sure, ask your doctor or pharmacist.
• If it's a medicine that can be thrown in the trash, take it out of the container, mix it with used cat litter, soil, or coffee grounds, put it in a sealable bag or container, and throw it in the trash. This is to prevent small children or animals from getting into it and causing an accident.

The most important things to keep in mind (Take-Home Message)

Okay, so we've talked a lot about this drug `Sacubitril; Valsartan` (Entresto), haven't we? Finally, here are the most important things to keep in mind:

• This medicine is an important medication that helps control your heart failure.
• Always take the prescribed dose at the prescribed time, as prescribed by your doctor. Do not skip meals or take more than you need.
• Be sure to tell your doctor about any other medications you are taking and any other illnesses you have.
• Do not take this medicine if you are pregnant or trying to get pregnant. Be especially careful.
• Be aware of side effects. Tell your doctor if you notice anything unusual.
• If you have any questions or doubts, don't be shy to ask your doctor or pharmacist.

If you follow these steps correctly, this medicine will be able to provide good results for your heart health. I wish you a speedy recovery! Sacubitril, Valsartan, Entresto, Heart Failure, Heart Disease, Heart Medicine, Blood Pressure