Drug interactions
Bretylium + Sacubitril-valsartan
Severity: Moderate
Bretylium and Sacubitril-valsartan: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Bretylium can cause significant hypotension by blocking norepinephrine release from sympathetic nerve endings. Together with sacubitril-valsartan, the hypotension can be additive and clinically important, especially on standing.
What this interaction means in plain words
Bretylium and Sacubitril-valsartan can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Additive hypotension from adrenergic neuron blockade and angiotensin receptor blockade with neprilysin inhibition.
What to do
Monitor blood pressure closely during bretylium therapy and consider reducing the sacubitril-valsartan dose if hypotension occurs. Use volume repletion or vasopressors as needed.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Sacubitril-valsartan
- Aliskiren + Sacubitril-valsartan Contraindicated
- Benazepril + Sacubitril-valsartan Contraindicated
- Captopril + Sacubitril-valsartan Contraindicated
- Enalapril + Sacubitril-valsartan Contraindicated
- Fosinopril + Sacubitril-valsartan Contraindicated
- Lisinopril + Sacubitril-valsartan Contraindicated
Frequently asked questions
Can I take Bretylium with Sacubitril-valsartan?
MediHelp rates the interaction as moderate. Bretylium and Sacubitril-valsartan can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Bretylium can cause significant hypotension by blocking norepinephrine release from sympathetic nerve endings. Together with sacubitril-valsartan, the hypotension can be additive and clinically important, especially on standing.
How serious is the interaction between Bretylium and Sacubitril-valsartan?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor blood pressure closely during bretylium therapy and consider reducing the sacubitril-valsartan dose if hypotension occurs. Use volume repletion or vasopressors as needed.
What other medicines interact with Sacubitril-valsartan?
MediHelp also lists interactions of Sacubitril-valsartan with, for example, Aliskiren, Benazepril, Captopril. The full list is on the Sacubitril-valsartan page.
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