Arnis TM 50 Tablet: Each film-coated tablet contains Sacubitril Valsartan Sodium Hemipentahydrate Complex INN equivalent to Sacubitril 24 mg and Valsartan 26 mg.
Arnis TM 100 Tablet: Each film-coated tablet contains Sacubitril Valsartan Sodium Hemipentahydrate Complex INN equivalent to Sacubitril 49 mg and Valsartan 51 mg.
Arnis TM is a combined preparation of Sacubitril and Valsartan. This combination contains a neprilysin inhibitor, Sacubitril, and an angiotensin-II receptor blocker, Valsartan. This combination inhibits neprilysin (neutral endopeptidase; NEP) via LBQ657, the active metabolite of the prodrug Sacubitril, and blocks the angiotensin II type-1 (AT1) receptor via Valsartan. The cardiovascular and renal effects of this combination in heart failure patients are attributed to the increased levels of peptides that are degraded by neprilysin, such as natriuretic peptides, by LBQ657, and the simultaneous inhibition of the effects of angiotensin II by Valsartan. Valsartan inhibits the effects of angiotensin II by selectively blocking the AT1 receptor, and also inhibits angiotensin II-dependent aldosterone release.
This combination can cause fetal harm when administered to a pregnant woman. Use of drugs that act on the renin-angiotensin system during the second and third trimesters of pregnancy reduces fetal renal function and increases fetal and neonatal morbidity & death.
There is no information regarding the presence of Sacubitril/Valsartan in human milk, the effects on the breastfed infant, or the effects on milk production. During treatment with this combination breast feeding is not recommended.
This combination may cause angioedema. If angioedema occurs, discontinue this combination immediately, provide appropriate therapy, & monitor for airway compromise. This combination lowers blood pressure and may cause symptomatic hypotension. Patients with an activated renin-angiotensin system, such as volume- and/or salt-depleted patients (e.g., those being treated with high doses of diuretics), are at greater risk. If hypotension occurs, consider dose adjustment of diuretics, concomitant antihypertensive drugs, and treatment of other causes of hypotension (e.g., hypovolemia). In elderly patients or with compromised renal function, concomitant use of NSAIDs, including COX-2 inhibitors with Sacubitril and Valsartan may result in worsening of renal function including possible acute renal failure. Through its actions on the Renin-Aldosterone System (RAAS), hyperkalemia may occur with this combination. Monitor serum potassium periodically and treat appropriately, especially in patients with risk factors for hyperkalemia such as severe renal impairment, diabetes, hypoaldosteronism, or a high potassium diet. Dosage reduction or interruption of this combination may be required.
Do not store above 30°C temperature. Keep away from light and wet place. Keep out of reach of children.