Table 14: Potential sacubitril/valsartan dosing and titration
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;
ARB, angiotensin receptor blocker;
BID, twice per day;
PO, orally;
RAAS, renin-angiotensin-aldosterone system