A washout period when switching from an ACEI to an ARNI is required to reduce the risk for angioedema; ACEI and ARNI combination therapy is contraindicated owing to this risk. Other contraindications that have been linked to ARNI include medication allergy, hyperkalemia, hypotension, and pregnancy; combination therapy with aliskiren is not recommended.
An ARNI may also be used in combination with an SGLT2 inhibitor; however, as these medications both have diuretic effects, dosages of concomitantly prescribed diuretics may need to be adjusted.
Learn more about the role of ARNIs in the treatment of HFrEF.
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Cite this: Alanna Morris, Michael Weber, Jeffrey J. Hsu. Fast Five Quiz: Heart Failure With Reduced Ejection Fraction (HFrEF) Treatment Optimization - Medscape - Nov 16, 2023.