Sacubitril sodium is primarily used in the treatment of heart failure. More specifically, it is utilized in the management of chronic heart failure with reduced ejection fraction (HFrEF), a condition in which the heart's ability to pump blood is compromised. When combined with valsartan (an angiotensin receptor blocker or ARB), it forms a combination drug called Entresto, which has become a standard treatment in this patient group.

Applications of Sacubitril Sodium:

1. Chronic Heart Failure with Reduced Ejection Fraction (HFrEF):

• Heart failure is a condition where the heart is unable to pump blood effectively. In HFrEF, the heart's left ventricle has difficulty contracting, leading to reduced blood flow and oxygen supply to tissues.

• Sacubitril sodium, in combination with valsartan (as Entresto), has been shown to reduce the risk of hospitalization and death related to heart failure.

• Mechanism: Sacubitril inhibits neprilysin, an enzyme that breaks down beneficial peptides, including natriuretic peptides. These peptides help in reducing blood pressure, improving blood vessel function, and promoting the excretion of sodium and water (diuresis). The combination with valsartan (which blocks the effects of angiotensin II, a hormone that constricts blood vessels) works synergistically to improve heart function.

2. Heart Failure with Reduced Ejection Fraction (HFrEF) — Symptom Management:

• In patients with HFrEF, sacubitril/valsartan can help to reduce symptoms of heart failure, such as shortness of breath, fatigue, and edema (fluid buildup).

• This combination can help to improve exercise tolerance and quality of life for patients with heart failure.

3. Reduction of Hospitalization and Mortality:

• Clinical studies have demonstrated that sacubitril/valsartan can reduce hospitalization rates due to heart failure and lower the risk of mortality compared to other standard treatments (like ACE inhibitors or ARBs alone).

4. Improvement in Cardiac Function:

• Sacubitril has a beneficial effect on cardiac remodeling, which is the process where the heart's structure and function change due to long-term stress or injury, such as in heart failure. This remodeling process can worsen heart function over time, and sacubitril helps counteract some of these changes.

Additional Notes:

• Patients with heart failure who do not respond well to traditional treatments (like ACE inhibitors or beta-blockers) may be switched to sacubitril/valsartan for better symptom control and outcomes.

• Sacubitril sodium can also help reduce the likelihood of progression from mild to severe heart failure.

Contraindications and Precautions:

• Sacubitril/valsartan should not be used in patients who have previously experienced angioedema (a serious allergic reaction) related to ACE inhibitors or other neprilysin inhibitors.

• It is not recommended for use during pregnancy or in patients with severe liver impairment.

• Kidney function, blood pressure, and potassium levels should be monitored during treatment.

In summary, sacubitril sodium is a key part of managing chronic heart failure, particularly HFrEF, by improving heart function, reducing symptoms, and lowering the risks of hospitalization and death.