Pharmaceutical class:

Angiotensin receptor blocker and neprilysin

Drug form:

24/26 (50) mg tablets – 51/49 (100) mg tablets – 103/97 (200) mg tablets

Drug ingredients:

Sacubitril/Valsartan

Mechanism of action of Elpidue:

Angiotensin receptor blocker and neprilysin

Uses of Elpidue:

Reducing the risk of death due to cardiovascular diseases and hospitalization due to heart failure in adult patients with chronic heart failure.
Treatment of symptomatic heart failure with systemic left ventricular systolic dysfunction in children aged one year and older

Use during pregnancy and breastfeeding Elpidue:

Pregnancy: Taking this medicine during pregnancy can cause damage or even death to the developing fetus. Therefore, its consumption is prohibited in the second and third trimesters of pregnancy, and it is not recommended in the first trimester of pregnancy.
Breastfeeding: Due to the possibility of unwanted side effects in infants, its use during breastfeeding is not recommended.

Pay attention to these points regarding the correct way of consumption:

Always take this medicine as directed by your doctor. If you are not sure, consult your doctor or pharmacist. The recommended dose of this drug is as follows:
Heart failure:
Adults – usually, the dosage at the beginning is Elpido 24/26 or Elpido 51/49 twice a day (one pill in the morning and one in the evening), which is determined by the doctor based on the previous use of other drugs.
Then, within 2 to 4 weeks and based on the patient’s response to the treatment, it is increased to the maintenance dose of Elpido 103/97 twice a day (one pill in the morning and one pill in the evening).
Children – consumption and its amount should be determined by the doctor.
Patients with renal failure: In patients with mild and moderate renal failure, there is no need to adjust the dose, and in patients with severe renal failure, it is recommended to start treatment with Elpido 24/26.
Patients with liver failure: In patients with mild liver failure, there is no need to adjust the dose, and in patients with moderate liver failure, it is recommended to start treatment with Elpido 24/26. Also, the use of this drug is not recommended in patients with severe liver failure.
• Take this medicine according to the doctor’s prescription. Avoid consuming more amounts or more often than prescribed by the doctor. The most effective drug is when the amount of drug in the blood is constant. In order to maintain a constant amount of medicine in the blood, do not forget any of the appointments. Take the medicine at a certain time of the day.
• Take the tablet with a glass of water
• This medicine can be taken with food or on an empty stomach.
• Halving or crushing tablets is not recommended.
• In case of overdose of this medicine, call the doctor immediately. In case of severe confusion or syncope, inform the doctor as soon as possible and lie down.
• If you miss a dose of this medicine, do not take the missed dose and resume your normal schedule. Do not double the amount of medicine. Before use, shake the product well so that the contents are uniform.
This product is only a nutritional supplement and is not for the prevention, diagnosis and treatment of diseases.

Elpidue drug interactions:

Before taking this medicine, inform your doctor if you are using the following medicines:
Angiotensin-converting enzyme inhibitors – the combined use of this drug and an angiotensin-converting enzyme inhibitor is prohibited due to the increased risk of angioedema.
A 36-hour interval should be considered between stopping the use and starting the use of each of these drugs.
Angiotensin receptor blockers – Do not take this medicine together with an angiotensin receptor blocker, because this medicine contains valsartan, an angiotensin II receptor blocker.
Aliskiren – The combined use of this drug with Aliskiren is prohibited in patients with diabetes or kidney failure.
Potassium-sparing diuretics (including spironolactone, triamterene, amiloride), potassium supplements or potassium-containing salt substitutes – simultaneous use of drugs may increase blood potassium.
Non-steroidal anti-inflammatory drugs including cyclooxygenase-2 selective inhibitors – simultaneous use of this drug with non-steroidal anti-inflammatory drugs including cyclooxygenase-2 inhibitors in elderly patients, patients with reduced volume (such as those who are treated with diuretics) or with renal dysfunction , may cause deterioration of renal function and acute renal failure. These effects are usually reversible. Monitoring of kidney function should be done periodically.
Lithium – An increase in the amount of lithium in the blood and lithium toxicity have been reported during the simultaneous administration of lithium with angiotensin II receptor antagonists. During simultaneous use, the serum lithium level should be monitored.
OATP1B1 and OATP1B3 substrates (including statins) – Sacubitril inhibits OATP1B1 and OATP1B3 transporters. This drug may increase the systemic exposure of OATP1B1 and OATP1B3 substrates, including statins. Concomitant use of sacubitril/valsartan with statins should be done with caution. No clinical interaction has been observed in the simultaneous use of this drug and simvastatin.
Sildenafil – Adding a dose of sildenafil to sacubitril/valsartan in patients with high blood pressure lowers blood pressure to a greater extent than administering sacubitril/valsartan alone. Therefore, it is necessary to observe caution when taking two drugs at the same time.
Rifampicin, cyclosporine, tenofovir, cidofovir and ritonavir – simultaneous use of sacubitril / valsartan with these drugs may cause more systemic exposure to the active metabolite of sacubitril or valsartan. Therefore, caution is necessary when starting or stopping the simultaneous use of two drugs.
Metformin – simultaneous use of Sacubitril / Valsartan with Metformin has reduced the maximum concentration of Metformin in the blood by 23%. In patients treated with metformin, the patient’s clinical condition should be evaluated at the start of sacubitril/valsartan treatment.

Precautions Elpidue:

• Visit your doctor regularly while taking this medicine to check its effectiveness and control unwanted side effects.
• If there is a possibility of pregnancy, talk to your doctor immediately. If this medicine is used during pregnancy, it may cause congenital abnormalities or other problems in the baby.
• This drug may cause angioedema. In case of angioedema, the drug should be stopped immediately and appropriate treatment should be applied. In such circumstances, avoid using this medicine again.
If angioedema is limited to the swelling of the face and lips, the symptoms usually resolve without treatment. Although the use of antihistamines can be useful in relieving the symptoms.
In cases where the tongue, trachea, or larynx is involved, the airway may be blocked. Angioedema with laryngeal edema may be fatal.
• Do not take this medicine at the same time with other medicines without informing your doctor. These medications, which may cause high blood pressure, include over-the-counter medications for appetite control, asthma, colds, coughs, hay fever, or sinusitis.
• When taking this medicine, if you get sick, especially if it is accompanied by severe or continuous nausea and vomiting, inform your doctor immediately. In such conditions, due to the loss of large amounts of body water, blood pressure may decrease.
• In case of exercising or being exposed to very hot weather, dizziness, fainting or syncope may occur. Heavy sweating can cause the loss of large amounts of body water and as a result lower blood pressure.
• If you feel confused or very tired while taking this medicine, avoid driving and working with equipment that requires complete alertness.
• Hallucinations, paranoia and sleep disorders may occur with the use of this medicine. In such a situation, drug use may be stopped.

Elpidue contraindications:

• Allergy to sacubitril, valsartan or any of the components of this medicine
• History of angioedema related to previous treatments with angiotensin converting enzyme inhibitors or angiotensin receptor blockers
• Combined use with angiotensin converting enzyme inhibitors
• Combined use with aliskiren in diabetic patients
• Severe liver disease
• Pregnancy

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