Entresto and Livalo

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Talk to your doctor before using sacubitril together with pitavastatin. Combining these medications may significantly increase the blood levels of pitavastatin. This can increase the risk of side effects such as liver damage and a rare but serious condition called rhabdomyolysis that involves the breakdown of skeletal muscle tissue. In some cases, rhabdomyolysis can cause kidney damage and even death. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications, or your doctor may prescribe alternative medications that do not interact. Let your doctor know immediately if you have unexplained muscle pain, tenderness, or weakness during treatment with pitavastatin or similar medications, especially if these symptoms are accompanied by fever or dark colored urine. You should also seek immediate medical attention if you develop fever, chills, joint pain or swelling, unusual bleeding or bruising, skin rash, itching, loss of appetite, fatigue, nausea, vomiting, dark colored urine, and/or yellowing of the skin or eyes, as these may be signs and symptoms of liver damage. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

MONITOR: Coadministration with sacubitril may increase the plasma concentrations of drugs that are substrates of organic anion transporting polypeptides (OATP) 1B1 and 1B3, such as some HMG-CoA reductase inhibitors (i.e., statins). The proposed mechanism is sacubitril-mediated inhibition of hepatic uptake transporters OATP1B1 and/or OATP1B3. Coadministration of sacubitril-valsartan with atorvastatin increased the Cmax and AUC of atorvastatin by up to 2-fold and 1.3 fold, respectively. High levels of HMG-CoA reductase inhibitory activity in plasma are associated with an increased risk of musculoskeletal toxicity. Myopathy manifested as muscle pain and/or weakness associated with grossly elevated creatine kinase exceeding ten times the upper limit of normal has been reported occasionally. Rhabdomyolysis has also occurred rarely, which may be accompanied by acute renal failure secondary to myoglobinuria and may result in death.

MANAGEMENT: Caution and close monitoring are advised if sacubitril must be used concomitantly with substrates of OATP1B1 and OATP1B3. All patients receiving statin therapy should be advised to promptly report any unexplained muscle pain, tenderness or weakness, particularly if accompanied by fever, malaise and/or dark colored urine. Therapy should be discontinued if creatine kinase is markedly elevated in the absence of strenuous exercise or if myopathy is otherwise suspected or diagnosed.

Entresto

Generic Name: sacubitril / valsartan

Brand name: Entresto

Synonyms: n.a.

What is Entresto?

Livalo

Generic Name: pitavastatin

Brand name: Livalo, Zypitamag

Synonyms: n.a.

What is Livalo?