The clinical relevance of drug–drug interaction between co-trimoxazole and sacubitril/valsartan treatment in a heart failure patient: a case report and overview of mechanisms and management in clinical practice
- 255 Downloads
Given the high prevalence of comorbidities needed to be treated in heart failure (HF) population, sacubitril/valsartan, which is the new promising therapy in HF, has been assessed for potential pharmacokinetic or pharmacodynamic drug–drug interactions that could result in adverse events. These potential complications pose a therapeutic dilemma, since they may deter the majority of patients from enjoying the cardiovascular benefits of sacubitril/valsartan (LCZ696) treatment  or even increase the burden of morbidity. Despite the existing evidence, real-world data on its safety in combination with concurrent medications are eagerly expected. We present an interesting case of a patient presenting with hyperkalemia caused by the co-administration of LCZ696 and co-trimoxazole (sulfamethoxazole/trimethoprim), highlighting the underlying pathophysiological mechanisms and the clinical approach to patients at risk of hyperkalemia caused by the drug interactions with the novel therapy,...
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
- 2.McMurray JJ (2016) The use of sacubitril/valsartan (LCZ696) in clinical practice. Br J Cardiol 23(suppl 1):S1-S16Google Scholar
- 3.U.S. Food and Drug Administration. ENTRESTO (sacubitril and valsartan). Highlights of prescribing information. http://www.accessdata.fda.gov/drugsatfda_docs/label/2015/207620Orig1s000lbl.pdf. Accessed 11 June 2017
- 4.Ponikowski P, Voors AA, Anker SD, Task Force Members et al (2016) ESC guidelines for the diagnosis and treatment of acute and chronic heart failure: the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure of the European Society of Cardiology (ESC) developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J 37:2129–2200CrossRefPubMedGoogle Scholar
- 7.Bistola V, Simitsis P, Farmakis D, Ikonomidis I, Bakosis G, Triposkiadis F, Hatziagelaki E, Lekakis J, Mebazaa A, Parissis J (2017) Association of mineralocorticoid receptor antagonist use and in-hospital outcomes in patients with acute heart failure. Clin Res Cardiol https://doi.org/10.1007/s00392-017-1161-7 (pMID: 28921054, [Epub ahead of print])CrossRefPubMedGoogle Scholar
- 8.Fu M, Ahrenmark U, Berglund S, Lindholm CJ, Lehto A, Broberg AM, Tasevska-Dinevska G, Wikstrom G, Ågard A, Andersson B, All investigators of the HR-HF study (2017) Adherence to optimal heart rate control in heart failure with reduced ejection fraction: insight from a survey of heart rate in heart failure in Sweden (HR-HF study). Clin Res Cardiol https://doi.org/10.1007/s00392-017-1146-6 (pMID: 28795299, [Epub ahead of print])PubMedPubMedCentralCrossRefGoogle Scholar
- 9.Fröhlich H, Torres L, Täger T, Schellberg D, Corletto A, Kazmi S, Goode K, Grundtvig M, Hole T, Katus HA, Cleland JGF, Atar D, Clark AL, Agewall S, Frankenstein L (2017) Bisoprolol compared with carvedilol and metoprolol succinate in the treatment of patients with chronic heart failure. Clin Res Cardiol https://doi.org/10.1007/s00392-017-1115-0 (pMID: 28434020, [Epub ahead of print])CrossRefPubMedGoogle Scholar
- 10.Yancy CW, Jessup M, Bozkurt B et al (2016) ACC/AHA/HFSA focused update on new pharmacological therapy for heart failure: an update of the 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. J Am Coll Cardiol 68:1476–1488CrossRefPubMedGoogle Scholar