Sacubitril Valsartan
Contraindicated
Textbook
Potentially excessive hypotension, increased risk of adverse effects.
Do not use in conjunction with other ARBs.
Source: G&G 14e · p602
Drug reference
Eprosartan
ARB · Antihypertensive
ARBAntihypertensive
CDSCO approvedSchedule H
EXCRETION
—
not curated
INTERACTIONS
12 major
incl. contraindicated
PREGNANCY
Contraindicated during the second and third trimesters due to risk of fetal hypotension, anuria, renal failure, malformations, or death. Increased teratogenic risk with first-trimester exposure.
FDA category + note
Top interactionssee all 12 →
- Sacubitril ValsartanContraindicatedTextbookG&G 14e · p602
- Angiotensin Converting Enzyme InhibitorsSevereTextbookHarrison 22e · p2396
- EnalaprilatSevereTextbookG&G 14e
- ImidaprilSevereTextbookHarrison 22e · p2396
Mechanism
Eprosartan is an angiotensin-II receptor antagonist that binds to the AT1 receptor with high affinity and selectivity over the AT2 receptor. It potently and selectively inhibits most biological effects of Angiotensin-II, including vascular smooth muscle contraction, pressor responses, aldosterone secretion, and increases in sympathetic tone. Unlike ACE inhibitors, it does not inhibit bradykinin metabolism, thus reducing the likelihood of a persistent dry cough.
Indications
HypertensionHeart failureDiabetic nephropathyChronic kidney diseaseAlternative for patients discontinuing ACE inhibitors due to persistent cough
Dosing
- Adult
- after any change in dose or during intercurrent illness. Other drugs used for Hypertension Amiloride hydrochloride, p. 243 . Chlortalidone, p. 244 . Cotriamterzide, p. 245 . Metolazone, p. Torasemide, p. 242 . Triamterene with chlortalidone, p. Xipamide, p. 245 ANTIHYPERTENSIVES, CENTRALLY ACTING Clonidine hydrochloride ▶ ▶ BY MOUTH ▶ Adult: Initially 50 micrograms twice daily for 2 we...
Pharmacokinetics
Peak effect
plasma levels are obtained 1 to 2 h after oral administration
Half-life
plasma t1/2 is 5 to 9 h
Metabolism
metabolized in part to a glucuronide conjugate
Excretion
Clearance is by renal elimination and biliary excretion
Contraindications
- Second and third trimesters of pregnancy
- First trimester of pregnancy (increased teratogenic risk)
- Hypotension (blood pressure below 90 mmHg, inferred from similar properties to ACE inhibitors)
- Unstable heart failure (inferred from similar properties to ACE inhibitors)
- Renal artery stenosis
- Concomitant use with ACE inhibitors or aliskiren (due to increased risk of hyperkalaemia, hypotension, and renal impairment)
Side effects
Common
Cough (uncommon, less likely than with ACE inhibitors)Hyperkalaemia (especially in patients with renal insufficiency or diabetes, and with dual RAS blockade)Altered sense of taste (inferred from ACE inhibitor similarity)Allergic skin rashes (inferred from ACE inhibitor similarity)Drug fever (inferred from ACE inhibitor similarity)hyperkalemiahypotensionskin rash
Serious
- Fetal hypotension, anuria, and renal failure (during pregnancy)
- Fetal malformations or death (during pregnancy)
- Acute renal failure (particularly in patients with bilateral renal artery stenosis or stenosis of the renal artery of a solitary kidney)
- Hypotension (especially with dual RAS blockade)
- Renal impairment (especially with dual RAS blockade)
- Angioedema (uncommon, less likely than with ACE inhibitors)
- angioedema
- anaphylaxis
- abnormal hepatic function
- hepatitis
- neutropenia
- leukopenia
- agranulocytosis
- pruritus
- urticaria
- hyponatremia
- alopecia
- vasculitis
- anemia
- fetopathic syndrome
- hepatic failure (rare)
- agranulocytosis (rare)
Pregnancy & lactation
Pregnancy
Contraindicated during the second and third trimesters due to risk of fetal hypotension, anuria, renal failure, malformations, or death. Increased teratogenic risk with first-trimester exposure.
Drug interactions
Angiotensin Converting Enzyme Inhibitors
Severe
Textbook
Greater incidence of acute kidney injury (AKI) and adverse cardiac events.
The combination of these two classes should be avoided.
Source: Harrison 22e · p2396
Enalaprilat
Severe
Textbook
Increased worsening of renal function, hypotension, syncope, and hyperkalemia without increased efficacy.
Not recommended for the treatment of hypertension. Previous studies indicate more harm than benefit.
Source: G&G 14e
Imidapril
Severe
Textbook
Greater incidence of acute kidney injury (AKI) and adverse cardiac events.
The combination of these two classes should be avoided.
Source: Harrison 22e · p2396
Aliskiren
Severe
Database
Increased risk of hypotension, hyperkalemia, and renal impairment.
Avoid concomitant use.
Source: DDInter
Amiloride
Severe
Database
Hyperkalemia.
Monitor K+ levels.
Source: DDInter
Benazepril
Severe
Database
Increased worsening of renal function, hypotension, syncope, and hyperkalemia without increased efficacy.
Not recommended for the treatment of hypertension. Previous studies indicate more harm than benefit.
Source: DDInter
Captopril
Severe
Database
Increased worsening of renal function, hypotension, syncope, and hyperkalemia without increased efficacy.
Not recommended for the treatment of hypertension. Previous studies indicate more harm than benefit.
Source: DDInter
Enalapril
Severe
Database
Increased worsening of renal function, hypotension, syncope, and hyperkalemia without increased efficacy.
Not recommended for the treatment of hypertension. Previous studies indicate more harm than benefit.
Source: DDInter
Fosinopril
Severe
Database
Increased worsening of renal function, hypotension, syncope, and hyperkalemia without increased efficacy.
Not recommended for the treatment of hypertension. Previous studies indicate more harm than benefit.
Source: DDInter
Lisinopril
Severe
Database
Increased worsening of renal function, hypotension, syncope, and hyperkalemia without increased efficacy.
Not recommended for the treatment of hypertension. Previous studies indicate more harm than benefit.
Source: DDInter
Lithium Carbonate
Severe
Database
Drug interaction classified as: excretion
Source: DDInter
Related guidelines
Chronic kidney disease — assessment and management
KDIGO · Nephrology · 2024
Heart failure in diabetes
RSSDI · Cardiology · 2023
Hypertension in chronic kidney disease
KDIGO · Nephrology · 2021
Chronic kidney disease — assessment and management
NICE · Nephrology · 2021
Chronic heart failure in adults
ESC · Cardiology · 2021
Other ARB drugs
Ask House about Eprosartan
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: Goodman & Gilman 14e, BNF·Verified: 2026-05-13 · House clinical team