Limited Use Note(s)

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SACUBITRIL & VALSARTAN24.3mg & 25.7mg Tab
Reason For Use CodeClinical Criteria
497For the treatment of heart failure (HF) with reduced ejection fraction in patients with New York Heart Association (NYHA) class II or III HF to reduce the incidence of cardiovascular (CV) death and HF hospitalization, if all of the following clinical criteria are met: - Reduced left ventricular ejection fraction (LVEF) (Less than 40%); - Patient has NYHA class II to III symptoms despite at least four weeks of treatment with a stable dose of an angiotensin-converting enzyme inhibitor (ACEI) or an angiotensin II receptor antagonist (ARB); and - In combination with a beta blocker and other recommended therapies, including an aldosterone antagonist (if tolerable).
LU Authorization Period: Indefinite.