Arnigen 50 Tablet

Angiotensin receptor–neprilysin inhibitor (ARNI) for:

• Chronic heart failure with reduced ejection fraction (reduces hospital admission and death)
• Heart failure in children 1 year and over (specialist)

Adults: start 49/51 mg (often called "100 mg") twice daily; double every 2–4 weeks as tolerated to the target 97/103 mg ("200 mg") twice daily.

• Start 24/26 mg ("50 mg") twice daily if: not previously on an ACE inhibitor/ARB or on low doses, eGFR 30–60, moderate liver impairment, elderly over 75, or low blood pressure (systolic 100–110).
• Stop ACE inhibitors at least 36 hours before starting (angioedema risk).
• With or without food.

• Use with an ACE inhibitor (or within 36 hours)
• History of angioedema with ACE inhibitors/ARBs, or hereditary angioedema
• Use with aliskiren in diabetes or eGFR < 60
• Severe liver impairment, biliary cirrhosis
• Pregnancy

Very common: low blood pressure, high potassium, worsening kidney function.

Common: dizziness, cough, fainting, tiredness, diarrhoea, nausea, low blood sugar in diabetics.

Rare but serious: angioedema (face/lip/tongue swelling — emergency), kidney failure.

• Check blood pressure, potassium and kidney function before and 1–2 weeks after starting and each increase.
• Avoid dehydration; stand up slowly.
• Renal artery stenosis: caution.

Contraindicated in pregnancy (fetal kidney damage). Not recommended while breastfeeding.

• ACE inhibitors (contraindicated); other ARBs, aliskiren (avoid)
• Potassium supplements, spironolactone/eplerenone, trimethoprim (high potassium)
• NSAIDs (kidney injury)
• Lithium (toxicity)
• Statins: atorvastatin levels may rise
• PDE-5 inhibitors (low blood pressure)

Low blood pressure. Lie down with legs raised; seek medical care.

Store below 30°C, protected from moisture.