Post-Discharge Initiation of Angiotensin Receptor-Neprilysin Inhibitor in an Inotrope-Dependent Patient in the Outpatient Setting: A Case Report

Purpose: Angiotensin receptor-neprilysin inhibitor (ARNI) therapy has been reported to be initiated in patients on vasoactive medications during acute decompensated heart failure. However, there is no report regarding the safety of initiating ARNI therapy in patients receiving inotrope infusion in a...

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Bibliographic Details
Published in:Hospital pharmacy (Philadelphia) 2021-12, Vol.56 (6), p.702-705
Main Authors: Ling, Hua, Patel, Nisha, Egolum, Ugochukwu O.
Format: Article
Language:English
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Summary:Purpose: Angiotensin receptor-neprilysin inhibitor (ARNI) therapy has been reported to be initiated in patients on vasoactive medications during acute decompensated heart failure. However, there is no report regarding the safety of initiating ARNI therapy in patients receiving inotrope infusion in an outpatient setting. Summary: We described a case of initiating post-discharge ARNI therapy in a 41-year-old man with inotrope-dependent heart failure in an outpatient setting. Two weeks after the initiation of low dose sacubitril/valsartan, milrinone was successfully discontinued without any adverse effects. Conclusion: With close monitoring, ARNI therapy could be safely initiated in hemodynamically stable patients receiving intravenous inotrope, and further investigation is needed to confirm our findings.
ISSN:0018-5787
1945-1253
DOI:10.1177/0018578720946756