Drug interactions
Sacubitril-valsartan + Telmisartan
Severity: Major
Sacubitril-valsartan and Telmisartan: 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
Combining two angiotensin receptor blockers provides duplicate RAAS blockade, as sacubitril-valsartan already contains valsartan. This raises the risk of hyperkalemia, hypotension and acute kidney injury without clear added benefit.
What this interaction means in plain words
Sacubitril-valsartan and Telmisartan 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 belongs to Cardiovascular; Telmisartan belongs to Cardiovascular.
Why it happens
Duplicate angiotensin II type 1 receptor blockade producing additive effects on potassium, blood pressure and renal function.
What to do
Avoid the combination and use a single angiotensin receptor blocking agent. If it is unavoidable, monitor potassium, creatinine and blood pressure closely.
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 Telmisartan
- Aliskiren + Telmisartan Contraindicated
- Sparsentan + Telmisartan Contraindicated
- Amifostine + Telmisartan Major
- Amiloride + Telmisartan Major
- Amlodipine-benazepril + Telmisartan Major
- Amlodipine-hydrochlorothiazide-valsartan + Telmisartan Major
Frequently asked questions
Can I take Sacubitril-valsartan with Telmisartan?
MediHelp rates the interaction as major. Sacubitril-valsartan and Telmisartan 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. Combining two angiotensin receptor blockers provides duplicate RAAS blockade, as sacubitril-valsartan already contains valsartan. This raises the risk of hyperkalemia, hypotension and acute kidney injury without clear added benefit.
How serious is the interaction between Sacubitril-valsartan and Telmisartan?
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 the combination and use a single angiotensin receptor blocking agent. If it is unavoidable, monitor potassium, creatinine and blood pressure closely.
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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