Drug interactions
Sacubitril-valsartan + Voclosporin
Severity: Major
Sacubitril-valsartan and Voclosporin: 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
Voclosporin is a calcineurin inhibitor that causes hyperkalemia and nephrotoxicity, and valsartan can add to both by lowering glomerular filtration pressure and potassium excretion. The combination raises the risk of acute kidney injury and elevated potassium.
What this interaction means in plain words
Sacubitril-valsartan and Voclosporin 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; Voclosporin belongs to Miscellaneous.
Why it happens
Additive hyperkalemic effects and hemodynamic renal effects (afferent vasoconstriction from calcineurin inhibition plus efferent dilation from RAAS blockade).
What to do
Monitor serum potassium and eGFR closely, especially at initiation and after dose changes. Reduce or interrupt voclosporin per labeling if renal function declines or hyperkalemia develops.
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 Voclosporin
- Clarithromycin + Voclosporin Contraindicated
- Cyclosporin + Voclosporin Contraindicated
- Ensitrelvir + Voclosporin Contraindicated
- Itraconazole + Voclosporin Contraindicated
- Ketoconazole + Voclosporin Contraindicated
- Posaconazole + Voclosporin Contraindicated
Frequently asked questions
Can I take Sacubitril-valsartan with Voclosporin?
MediHelp rates the interaction as major. Sacubitril-valsartan and Voclosporin 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. Voclosporin is a calcineurin inhibitor that causes hyperkalemia and nephrotoxicity, and valsartan can add to both by lowering glomerular filtration pressure and potassium excretion. The combination raises the risk of acute kidney injury and elevated potassium.
How serious is the interaction between Sacubitril-valsartan and Voclosporin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor serum potassium and eGFR closely, especially at initiation and after dose changes. Reduce or interrupt voclosporin per labeling if renal function declines or hyperkalemia develops.
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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