Sacubitril/valsartan sodium tablets are highly effective in treating heart failure and hypertension, but like all medications, they may also cause some side effects.

I. What are the common side effects?

1. Hypotension:

This is the most common side effect, presenting as dizziness, fatigue, especially when standing up or getting up.

2. Hyperkalemia:

Excessively high blood potassium can lead to muscle weakness, arrhythmias, and in severe cases, life-threatening conditions.

3. Renal impairment:

(1) Including renal dysfunction and renal failure.

(2) Regular monitoring of serum creatinine and blood urea nitrogen levels is required during medication.

4. Cough:

Some patients may experience a dry cough, but the incidence is lower than with traditional ACEI antihypertensive drugs.

5. Angioedema:

(1) Although rare, it is a serious side effect. It manifests as swelling of the lips, eyelids, tongue, or throat, which may affect breathing.

(2) Other reactions: including dizziness, headache, fatigue, nausea, anemia, rash, etc. Most symptoms are mild and tolerable.

II. Identifying serious side effects

1. Warning signs requiring immediate medical attention:

(1) If you experience facial or throat swelling, difficulty breathing, or hoarseness, it may be angioedema requiring emergency treatment.

(2) Additionally, severe dizziness with loss of consciousness, severe chest pain, significantly reduced urine output, convulsions, or altered consciousness should prompt immediate medical attention.

2. Routine monitoring indicators:

(1) During treatment, regular checks of blood pressure, serum potassium, renal function (eGFR), and liver function should be performed.

(2) Typically, retesting within 2-4 weeks after starting medication or dose adjustment, then every 3-6 months once stabilized.

III. Ways to manage side effects

1. Managing hypotension:

(1) Rise slowly when getting up, pausing for a moment at each step from lying to sitting to standing.

(2) Avoid prolonged standing, hot baths, or excessive sweating. If dizziness occurs frequently, inform your doctor to adjust the dose.

2. Managing hyperkalemia:

(1) Avoid high-potassium foods such as bananas, oranges, potatoes, spinach, soy products, and low-sodium salt (which often contains potassium chloride).

(2) Consult your doctor for a dietary plan suitable for you.

3. Managing renal function fluctuations:

Maintain adequate fluid intake and avoid dehydration. Avoid concomitant use of NSAIDs (e.g., ibuprofen, diclofenac), as they can worsen kidney burden.

4. Managing cough and fatigue:

(1) Mild dry cough usually lessens over time.

(2) Fatigue is more common early in treatment; ensure adequate rest and avoid driving or operating dangerous machinery until you have adapted.

5. Managing rash or itching:

Avoid scratching, use a mild moisturizer. If the rash spreads or is accompanied by fever, seek medical evaluation.

IV. Contraindications and absolute precautions

1. The following conditions prohibit the use of this drug:

(1) Allergy to any ingredient; currently taking or less than 36 hours after stopping ACEI drugs; history of angioedema; severe hepatic impairment; pregnant or potentially pregnant women.

(2) Diabetic patients should not use this drug in combination with aliskiren.

V. Proper storage conditions

1. Temperature requirements:

(1) Store at room temperature, i.e., 15-25°C or a normal environment of 1-30°C.

(2) Avoid storing in humid, hot places such as bathrooms or kitchens.

2. Protect from light and moisture:

(1) Keep in the original packaging to protect from direct sunlight.

(2) Close the bottle cap tightly immediately after use.

3. Expiration date:

(1) The shelf life of both tablets and pediatric granules is 3 years.

(2) Do not use expired medication.

4. Child safety:

(1) Store out of reach of children.

(2) The capsule container of pediatric granules is the outer packaging; the inner microparticle tablets should be taken after removal. Do not swallow the whole capsule.

5. Disposal:

Expired or unused medication should be disposed of through proper take-back programs. Do not flush down the toilet or discard in household trash.