How Do Neprilysin Inhibitors Work?

Neprilysin inhibitors are a new class of drugs used to treat high blood pressure and heart failure. They work by blocking the action of neprilysin thus preventing the breakdown of natriuretic peptides.

Neprilysin enzyme is also called neutral endopeptidase that plays a role in the degradation of natriuretic peptides and other vasoactive peptides including bradykinin. Natriuretic peptides remove sodium from the blood and excrete it in the urine. In the absence of natriuretic peptides, sodium levels increase in the blood, leading to increased blood pressure.

Bradykinin is a vasodilator that relaxes and widens the walls of blood vessels. This facilitates the free flow of blood in the vessels. In the absence of bradykinin, the blood vessels may not relax and may cause an increase in blood pressure.

Neprilysin inhibitor increases the availability of natriuretic peptides, helps bradykinin to achieve vasodilation and natriuresis (excretion of sodium), and decreases blood pressure.

Neprilysin inhibitors are used to treat:

• Severe symptomatic heart failure with reduced ejection fraction with New York Heart Association class II, III, or IV
• High blood pressure

Common side effects include:

• Cough
• Dizziness
• Lightheadedness

Serious side effects may include:

• Hypotension (decrease in blood pressure)
• Hyperkalemia (high potassium levels in the blood)
• Renal failure
• Angioedema (swelling of skin or tissue)

The information contained herein is not intended to cover all possible side effects, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Check with your doctor or pharmacist to make sure these drugs do not cause any harm when you take them along with other medicines. Never stop taking your medication and never change your dose or frequency without consulting your doctor.

Drug names include:

• Entresto
• Sacubitril/valsartan