Drug interactions
Candesartan + Sacubitril-valsartan
Severity: Major
Candesartan and Sacubitril-valsartan: major 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
Sacubitril-valsartan already contains an angiotensin receptor blocker, so adding candesartan produces duplicate blockade of the AT1 receptor. This increases the risk of hypotension, hyperkalemia and acute kidney injury without proven added benefit.
What this interaction means in plain words
Candesartan and Sacubitril-valsartan can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Candesartan belongs to Cardiovascular; Sacubitril-valsartan belongs to Cardiovascular.
Why it happens
Duplicate angiotensin II type 1 receptor blockade with additive effects on aldosterone suppression and renal hemodynamics.
What to do
Avoid concurrent use and prescribe only one angiotensin receptor blocker. If switching, stop candesartan before starting sacubitril-valsartan and monitor potassium and creatinine.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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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
Other interactions of Candesartan
- Aliskiren + Candesartan Contraindicated
- Candesartan + Sparsentan Contraindicated
- Amifostine + Candesartan Major
- Amiloride + Candesartan Major
- Amlodipine-benazepril + Candesartan Major
- Amlodipine-hydrochlorothiazide-valsartan + Candesartan Major
Frequently asked questions
Can I take Candesartan with Sacubitril-valsartan?
MediHelp rates the interaction as major. Candesartan and Sacubitril-valsartan can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Sacubitril-valsartan already contains an angiotensin receptor blocker, so adding candesartan produces duplicate blockade of the AT1 receptor. This increases the risk of hypotension, hyperkalemia and acute kidney injury without proven added benefit.
How serious is the interaction between Candesartan and Sacubitril-valsartan?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid concurrent use and prescribe only one angiotensin receptor blocker. If switching, stop candesartan before starting sacubitril-valsartan and monitor potassium and creatinine.
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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