Why the study?
Does the coadministration of sacubitril/valsartan and sildenafil alter pharmacokinetics or blood pressure compared to sacubitril/valsartan alone in patients with mild-to-moderate hypertension?
Does the coadministration of sacubitril/valsartan and sildenafil alter pharmacokinetics or blood pressure compared to sacubitril/valsartan alone in patients with mild-to-moderate hypertension?
Coadministration of sacubitril/valsartan and sildenafil reduces valsartan exposure and causes additional blood pressure lowering, warranting caution when used together in clinical practice.
Warrants blood pressure monitoring when coadministering sacubitril/valsartan and sildenafil;.
Sacubitril/valsartan (LCZ696) is indicated for the treatment of patients with heart failure and reduced ejection fraction (HFrEF). Since patients with HFrEF may receive sacubitril/valsartan and sildenafil, both increasing cyclic guanosine monophosphate, the present study evaluated the pharmacokinetic and pharmacodynamic drug interaction potential between sacubitril/valsartan and sildenafil. In this open‐label, three‐period, single sequence study, patients with mild‐to‐moderate hypertension (153.8 ± 8.2 mmHg mean systolic blood pressure (SBP)) received a single dose of sildenafil 50 mg, sacubitril/valsartan 400 mg once daily for 5 days, and sacubitril/valsartan and sildenafil coadministration. When coadministered with sildenafil, the AUC and C max of valsartan decreased by 29% and 39%, respectively. Coadministration of sacubitril/valsartan and sildenafil resulted in a greater decrease in BP (–5/–4/–4 mmHg mean ambulatory SBP/DBP/MAP (mean arterial pressure)) than with sacubitril/valsartan alone. Both treatments were generally safe and well tolerated in this study; however, the additional BP reduction suggests that sildenafil should be administered cautiously in patients receiving sacubitril/valsartan. Unique identifier: NCT01601470.
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Hsiao et al. (2017) studied this question.
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