Neptaz 50 mg

• Reduces strain on a weakened heart

• Helps improve blood flow around the body

• Lowers the risk of heart-failure hospitalisation

• Reduces the risk of cardiovascular death

• Helps control fluid-related pressure

• Supports long-term heart-failure management

• Can help improve breathlessness and exercise tolerance

• Combines two complementary medicines in one tablet

The benefits develop through consistent treatment. Neptaz should not be stopped simply because symptoms begin to improve.

Neptaz contains two ingredients that support the heart in different ways.

Sacubitril blocks an enzyme called neprilysin. This increases the activity of helpful natural substances called natriuretic peptides. These substances relax blood vessels, help the body remove excess sodium and water and reduce pressure inside the heart.

Valsartan blocks the action of angiotensin II, a substance that narrows blood vessels and encourages salt and fluid retention. Blocking angiotensin II allows blood vessels to relax and reduces the workload on the heart.

Together, these actions improve blood flow, reduce fluid-related pressure and make it easier for the weakened heart to pump blood around the body.

Neptaz 50 mg contains the lower tablet strength of sacubitril 24 mg and valsartan 26 mg. When this strength is selected for an adult, the usual schedule is one tablet twice daily, approximately 12 hours apart.

The usual adult starting dose of sacubitril and valsartan is 49 mg/51 mg twice daily. The lower 24 mg/26 mg twice-daily dose may be selected for patients who are not already taking an ACE inhibitor or ARB, were previously taking a low dose of these medicines, have severe kidney impairment or have moderate liver impairment.

When tolerated, the dose is generally increased every two to four weeks towards the target dose of 97 mg/103 mg twice daily. These are established dosing ranges and should not be used to change the dose without an updated treatment plan.

An ACE inhibitor must be stopped for at least 36 hours before Neptaz is started because taking the two medicines too close together increases the risk of angioedema.

Common Side Effects

Common side effects of Neptaz 50 mg include low blood pressure, dizziness, light-headedness, cough, tiredness, headache, nausea and diarrhoea. It can also increase blood potassium or cause changes in kidney-function test results. Dizziness is more likely when standing up quickly, during dehydration or when Neptaz is combined with other medicines that lower blood pressure.

Serious Side Effects

Serious reactions require immediate medical attention. Warning signs include swelling of the face, lips, tongue or throat; difficulty breathing or swallowing; fainting; a significant reduction in urination; severe weakness; confusion; or an irregular heartbeat. These symptoms can indicate angioedema, severely low blood pressure, kidney dysfunction or dangerously high potassium levels.

Neptaz 50 mg should be avoided by:

• People allergic to sacubitril or valsartan

• Pregnant women

• Women planning a pregnancy

• People with hereditary angioedema

• People with previous ACE inhibitor-related angioedema

• People with previous ARB-related angioedema

• People currently taking an ACE inhibitor

• People who stopped an ACE inhibitor less than 36 hours ago

• People taking another ARB or valsartan product

• Diabetic patients taking aliskiren

• People with severe liver impairment

• Breastfeeding women

• Children without a paediatric heart specialist’s instructions

People with low blood pressure, dehydration, kidney disease or high potassium require careful assessment and monitoring rather than automatically using the standard dose.

Tell the healthcare provider about all medicines, supplements and salt substitutes being used. Important interactions include:

• ACE inhibitors

• Other ARB medicines

• Other valsartan products

• Aliskiren

• Potassium supplements

• Potassium-containing salt substitutes

• Potassium-sparing diuretics

• NSAID painkillers

• Lithium

• Other blood pressure medicines

• High-dose diuretics

Neptaz already contains valsartan and should not be combined with another valsartan or ARB medicine. Potassium supplements and potassium-sparing diuretics can raise blood potassium, while NSAIDs can increase the risk of reduced kidney function. Lithium levels can also rise and become toxic.

• Keep Neptaz 50 mg in its original packaging.

• Store the tablets below 30°C.

• Keep them in a cool and dry place.

• Protect the tablets from moisture.

• Keep them away from direct sunlight and heat.

• Do not remove a tablet until it is required.

• Keep the medicine away from children and pets.

• Do not use damaged or discoloured tablets.

• Do not use the medicine after its expiry date.