| Higher dose of RAAS inhibitor | |
|---|---|
| ACEI | ARB |
|
Enalapril: ≥10mg/d Lisinopril: ≥10mg/d Perindopril: ≥4mg/d Ramipril: ≥5 mg/d |
Candesartan: ≥ 16 mg/d Irbesartan: ≥ 150 mg/d Losartan: ≥ 50 mg/d Olmesartan: ≥ 10 mg/d Telmisartan: ≥ 40 mg/d Valsartan: ≥ 160 mg/d |
| Initial Dose* | |
| 100 mg PO BID | |
| Titration | |
| Over 3-6 weeks, increase to target 200 mg PO BID | |
| Lower dose of RAAS inhibitor |
|---|
| Initial Dose* |
| 50 - 100mg PO BID |
| Titration |
| Over 6 weeks, increase to target 200 mg PO BID |
| Higher risk of hypotension (e.g. low baseline SBP, poor renal function) |
|---|
| Initial Dose* |
| 50mg PO BID |
| Titration |
| Over 6 weeks, increase to target 200 mg PO BID |
*Health Canada labelled dose of 50 mg BID is 24.3 mg sacubitril/25.7 mg valsartan, 100 mg BID is 48.6 mg sacubitril/51.4 mg valsartan and 200 mg is 97.2 mg sacubitril/102.8 mg valsartan.
ACEi, angiotensin converting enzyme inhibitor;