Enalapril
Contraindicated
Database
Increased rate of angioedema, a rare but life-threatening condition.
The combination is contraindicated. Discontinue ACEI or ARB, and then add ARNI.
Drug reference
sacubitril
Drug monograph
CDSCO approved
EXCRETION
—
not curated
INTERACTIONS
4 major
incl. contraindicated
PREGNANCY
—
not curated
Top interactions
- EnalaprilContraindicatedDatabase
- PerindoprilContraindicatedDatabaseKimi deep-research + Cla
- RamiprilContraindicatedDatabase
- MoexiprilSevereDatabaseDDInter
Mechanism
Sacubitril is an inhibitor of neprilysin, an enzyme that degrades ANP and BNP.
Indications
heart failure
Pharmacokinetics
Half-life
LBQ657, which has a t1/2 of 11 h
Bioavailability
about 60%
Protein binding
highly protein bound (94%–97%)
Metabolism
metabolized by esterases into the active metabolite LBQ657
Drug interactions
Perindopril
Contraindicated
Database
Additive angioedema risk (dual neprilysin/ACE)
Do not combine; ≥36 h washout
Source: Kimi deep-research + Cla
Ramipril
Contraindicated
Database
Fatal angioedema
Wait 36 hours after stopping ACEi before starting ARNI.
Moexipril
Severe
Database
Clinical effect not specified
Source: DDInter
8 additional low-confidence interactions hidden — those rows lack a documented mechanism or management plan in our sources.
Related guidelines
Other Unclassified drugs
Ask House about sacubitril
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: Goodman & Gilman 14e·Verified: 2026-05-10 · House clinical team