Vivanta
Generic Name
Sacubitril and Valsartan
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| vivanta 49 mg tablet | ৳ 80.00 | ৳ 800.00 |
Description
Overview of the medicine
Vivanta 49 mg Tablet contains a combination of Sacubitril and Valsartan. It is used to treat chronic heart failure with reduced ejection fraction in adult patients. It helps to reduce the risk of cardiovascular death and hospitalization for heart failure.
Uses & Indications
Dosage
Adults
Recommended starting dose is Sacubitril 24 mg / Valsartan 26 mg orally twice daily. Double the dose every 2-4 weeks to the target dose of 97 mg / 103 mg twice daily, as tolerated. Vivanta 49 mg is an intermediate dose.
Elderly
No dosage adjustment required based on age. Follow adult dosing.
Renal_impairment
Mild to moderate (eGFR 30-60 mL/min/1.73 m²): Consider starting with 24 mg/26 mg twice daily. Severe (eGFR <30 mL/min/1.73 m²): Not recommended or reduced starting dose with careful monitoring.
How to Take
Take orally, with or without food, twice daily (morning and evening).
Mechanism of Action
Sacubitril is a neprilysin inhibitor, preventing the breakdown of natriuretic peptides which exert beneficial effects on the heart. Valsartan is an angiotensin II receptor blocker (ARB), which inhibits the vasoconstrictor and aldosterone-secreting effects of angiotensin II.
Pharmacokinetics
Onset
Clinical effects seen within a week, full effect takes longer.
Excretion
Primarily renal (LBQ657) and fecal (Valsartan).
Half life
LBQ657: 10-13 hours; Valsartan: 9.9 hours.
Absorption
Sacubitril is a prodrug, converted to its active metabolite (LBQ657). Rapidly absorbed, Cmax for LBQ657 reached in 2 hours. Valsartan Cmax in 1.5-3 hours.
Metabolism
Sacubitril is converted to active LBQ657 by esterases. Valsartan is minimally metabolized.
Side Effects
Contraindications
- Concomitant use with ACE inhibitors (risk of angioedema).
- History of angioedema related to previous ACE inhibitor or ARB therapy.
- Pregnancy.
- Severe hepatic impairment.
- Concomitant use with aliskiren in patients with diabetes or renal impairment.
Drug Interactions
NSAIDs
May reduce antihypertensive effect and increase risk of renal impairment.
Lithium
Increased serum lithium concentrations and toxicity.
Aliskiren
Contraindicated in diabetic or renally impaired patients due to increased risk of hyperkalemia, renal dysfunction, and hypotension.
ACE inhibitors
Increased risk of angioedema; must not be co-administered within 36 hours of each other.
Potassium-sparing diuretics/Potassium supplements
Increased risk of hyperkalemia.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms include severe hypotension. Treatment is symptomatic and supportive. Hemodialysis is not effective for removing LBQ657 (active metabolite of sacubitril) or valsartan.
Pregnancy & Lactation
Contraindicated during pregnancy due to fetal toxicity. Not recommended during breastfeeding as it is unknown if components pass into breast milk.
Side Effects
Contraindications
- Concomitant use with ACE inhibitors (risk of angioedema).
- History of angioedema related to previous ACE inhibitor or ARB therapy.
- Pregnancy.
- Severe hepatic impairment.
- Concomitant use with aliskiren in patients with diabetes or renal impairment.
Drug Interactions
NSAIDs
May reduce antihypertensive effect and increase risk of renal impairment.
Lithium
Increased serum lithium concentrations and toxicity.
Aliskiren
Contraindicated in diabetic or renally impaired patients due to increased risk of hyperkalemia, renal dysfunction, and hypotension.
ACE inhibitors
Increased risk of angioedema; must not be co-administered within 36 hours of each other.
Potassium-sparing diuretics/Potassium supplements
Increased risk of hyperkalemia.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms include severe hypotension. Treatment is symptomatic and supportive. Hemodialysis is not effective for removing LBQ657 (active metabolite of sacubitril) or valsartan.
Pregnancy & Lactation
Contraindicated during pregnancy due to fetal toxicity. Not recommended during breastfeeding as it is unknown if components pass into breast milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months
Availability
Pharmacies, hospitals
Approval Status
Approved by FDA and DGDA
Patent Status
Patent expired for original molecule, generic versions available
WHO Essential Medicine
YesClinical Trials
The PARADIGM-HF trial demonstrated superior efficacy of Sacubitril/Valsartan over enalapril in reducing cardiovascular death and hospitalization for heart failure.
Lab Monitoring
- Monitor serum potassium levels regularly.
- Monitor renal function (eGFR, serum creatinine).
- Monitor blood pressure.
Doctor Notes
- Monitor for signs of angioedema, especially in patients with a history of ACE inhibitor-induced angioedema.
- Check renal function and potassium levels before starting and regularly during treatment.
- Avoid concomitant use with ACE inhibitors (36-hour washout period).
Patient Guidelines
- Take as prescribed, do not stop without consulting your doctor.
- Avoid potassium-rich foods or supplements unless advised by doctor.
- Report any swelling of the face, lips, tongue, or throat (signs of angioedema) immediately.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose.
Driving Precautions
May cause dizziness or fatigue. Patients should be cautious when driving or operating machinery until they know how the medication affects them.
Lifestyle Advice
- Maintain a heart-healthy diet.
- Regular exercise as advised by doctor.
- Limit sodium intake.
- Avoid smoking and excessive alcohol consumption.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.
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