Clinical Research in Cardiology

, Volume 107, Issue 6, pp 524–526 | Cite as

The clinical relevance of drug–drug interaction between co-trimoxazole and sacubitril/valsartan treatment in a heart failure patient: a case report and overview of mechanisms and management in clinical practice

  • Eleni S. Nakou
  • Maria E. Marketou
  • Panos E. Vardas
  • Fragiskos I. Parthenakis
Letter to the Editors


Given the high prevalence of comorbidities needed to be treated in heart failure (HF) population, sacubitril/valsartan, which is the new promising therapy in HF, has been assessed for potential pharmacokinetic or pharmacodynamic drug–drug interactions that could result in adverse events. These potential complications pose a therapeutic dilemma, since they may deter the majority of patients from enjoying the cardiovascular benefits of sacubitril/valsartan (LCZ696) treatment [1] or even increase the burden of morbidity. Despite the existing evidence, real-world data on its safety in combination with concurrent medications are eagerly expected. We present an interesting case of a patient presenting with hyperkalemia caused by the co-administration of LCZ696 and co-trimoxazole (sulfamethoxazole/trimethoprim), highlighting the underlying pathophysiological mechanisms and the clinical approach to patients at risk of hyperkalemia caused by the drug interactions with the novel therapy,...


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Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of CardiologyHeraklion University HospitalHeraklion-CreteGreece

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