Sacubitril and Perindopril: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 9, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Perindopril
Sacubitril
No brand names on record
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Increased risk of angioedema
Interaction Deep Dive
Administering sacubitril/valsartan concomitantly with an ACE inhibitor is contraindicated because of the increased risk of adverse effects, including angioedema. Do not administer sacubitril/valsartan within 36 hours of administering an ACE inhibitor12.
Why it happens (mechanism)
Additive adverse effects, including angioedema
Common questions
Can I take Sacubitril and Perindopril together?
Increased risk of angioedema Always confirm with your pharmacist or prescriber before making any change.
How serious is the Sacubitril and Perindopril interaction?
It is rated contraindicated. These should generally not be used together.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Sacubitril or Perindopril need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (2)
- Product Information: Zestril(R) oral tablets, lisinopril oral tablets. Almatica Pharma, Inc (per FDA), Pine Brook, NJ, 2017. DailyMed
- Product Information: ENTRESTO(TM) oral tablets, sacubitril valsartan oral tablets. Novartis Pharmaceuticals Corporation (per Manufacturer), East Hanover, NJ, 2015. DailyMed
Keep reading about Perindopril
Keep reading about Sacubitril
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