azmarda 50mg tablet - Sacubitril (24mg) + Valsartan (26mg) medicine

Azmarda 50mg Tablet: A Comprehensive Guide to Uses, Side Effects, and Safety

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🏭 J B Chemicals and Pharmaceuticals Ltd 📦 Varies by brand 💊 Allopathy 📅 Updated: Sep 23, 2026
⚠️ Nephrotoxicity Risk 🤰 Pregnancy Category This medicine is contraindicated during pregnancy. It can cause fetal harm, including oligohydramnios, fetal renal dysfunction, and death. Women of childbearing potential should use effective contraception. If pregnancy is detected, discontinue this medicine immediately and consult your doctor. 📋 Prescription Required 💊 Generic Available
Medically Reviewed
11 min read
Evidence: High
Reviewed by
SaathiMed Expert Panel | Sep 23, 2026

When to Call Your Doctor IMMEDIATELY

  • Swelling of the face, lips, throat, or tongue
  • Difficulty breathing or swallowing
  • Severe dizziness or fainting
  • Decreased urine output or swelling in legs
  • Irregular heartbeat or muscle weakness
  • Severe abdominal pain with nausea or vomiting

If experiencing severe symptoms, call emergency services immediately.

What is azmarda 50mg tablet used for?

This medicine is a combination of sacubitril and valsartan used to treat heart failure with reduced ejection fraction. It works by relaxing blood vessels and reducing strain on the heart, thereby lowering the risk of hospitalization and death.

  • Generic Name: Sacubitril + Valsartan
  • Manufacturer: J B Chemicals and Pharmaceuticals Ltd
  • Form: Allopathy
  • Pregnancy Category: Consult doctor
  • Prescription Required: Yes

🇮🇳 azmarda 50mg tablet के बारे में (Hindi Summary)

उपयोग: यह दवा सैक्यूबिट्रिल और वाल्सार्टन का संयोजन है, जिसका उपयोग हृदय विफलता (हार्ट फेल्योर) के इलाज के लिए किया जाता है। यह दिल की मांसपेशियों को आराम देकर और रक्त वाहिकाओं को फैलाकर दिल पर दबाव कम करती है। इससे सांस फूलना, थकान और पैरों में सूजन जैसे लक्षणों में सुधार होता है और अस्पताल में भर्ती होने का खतरा कम होता है।

साइड इफेक्ट्स: इस दवा के सामान्य दुष्प्रभावों में चक्कर आना, कम रक्तचाप, खांसी, और गुर्दे की समस्याएं शामिल हैं। कुछ रोगियों में पोटेशियम का स्तर बढ़ सकता है। गंभीर दुष्प्रभावों में चेहरे, होंठ, गले या जीभ में सूजन (एंजियोएडेमा) शामिल है, जिसके लिए तत्काल चिकित्सा सहायता की आवश्यकता होती है।

सुरक्षा सलाह: इस दवा को केवल डॉक्टर के निर्देशानुसार ही लें। खुराक को बदलें या दवा बंद करने से पहले डॉक्टर से सलाह लें। पोटेशियम सप्लीमेंट या नमक के विकल्प का सेवन बिना डॉक्टर की सलाह के न करें। यदि आप गर्भवती हैं या स्तनपान करा रही हैं, तो डॉक्टर को बताएं। इस दवा से चक्कर आ सकते हैं, इसलिए वाहन चलाने या मशीनरी चलाने से बचें। नियमित रूप से रक्त परीक्षण कराएं।

💡 Did You Know? India is the largest provider of generic medicines globally, supplying over 50% of global vaccine demand.

💊 azmarda 50mg tablet Uses & Benefits

  • [{"condition":"Heart failure with reduced ejection fraction (HFrEF)","description":"This medicine is indicated to reduce the risk of cardiovascular death and hospitalization for heart failure in adults with chronic heart failure and reduced ejection fraction.
  • It is typically used in place of an ACE inhibitor or ARB.","evidence":"Well-established"}]

Off-label uses: [{"condition":"Heart failure with preserved ejection fraction (HFpEF)","description":"Some clinicians may prescribe this medicine off-label for HFpEF, but its efficacy in this condition is not as well established as in HFrEF.","evidence":"Limited"}]

Primary treatment for: Heart failure with reduced ejection fraction

Also treats: Hypertension, Chronic kidney disease, Diabetes

📋 Drug Information

Generic Name(s)Sacubitril + Valsartan
Brand NameAzmarda 50mg Tablet
ManufacturerJ B Chemicals and Pharmaceuticals Ltd
Packaging / FormVaries by brand (Allopathy)
Therapeutic ClassCARDIAC
Action ClassAngiotensin Receptor Neprilysin Inhibitor (ARNI)
Route of AdministrationOral
StorageStore at room temperature between 15°C and 30°C (59°F to 86°F). Keep in the original container to protect from moisture. Do not refrigerate or freeze.
Shelf Life24 months from the date of manufacture.
WHO GuidelineThe World Health Organization does not have specific guidelines for this medicine. However, major cardiology societies recommend ARNIs as first-line therapy for HFrEF.
ICMR GuidelineThe Indian Council of Medical Research (ICMR) does not have specific guidelines for this medicine. However, Indian cardiology societies follow international guidelines recommending ARNIs for HFrEF.

👨‍⚕️ Doctor's Practical Tips

Evidence-based practical advice from experienced clinicians

1
Always take this medicine with or without food, but at the same time each day.
2
Monitor your blood pressure regularly and report any dizziness or fainting.
3
Get your kidney function and potassium levels checked periodically.
4
Do not take potassium supplements or salt substitutes without consulting your doctor.
5
If you experience swelling of the face, lips, or throat, seek emergency care immediately.
6
Avoid alcohol as it can worsen dizziness and low blood pressure.
7
Do not stop this medicine abruptly; consult your doctor first.

🔍 Is This Medicine Right for Your Symptom?

Educational reference. Always consult a doctor for diagnosis.

Shortness of breath
This medicine is commonly prescribed for heart failure, which causes breathlessness.
Likely Use
Swelling in legs
This medicine helps reduce fluid retention in heart failure.
Likely Use
Fever
This medicine is not a fever reducer.
Not Primary
Headache
This medicine is not primarily used for headaches.
Not Primary

🔬 How This Medicine Works (Pharmacology)

Pharmacokinetics

AbsorptionFollowing oral administration, sacubitril and valsartan are rapidly absorbed. The absolute bioavailability of sacubitril is estimated to be at least 60%. Valsartan has an absolute bioavailability of about 23%. Food has no significant effect on the absorption of this medicine.
DistributionBoth sacubitril and valsartan are highly bound to plasma proteins. Sacubitril and its active metabolite LBQ657 are approximately 94-97% bound to plasma proteins. Valsartan is about 95% bound to serum proteins, primarily albumin. The volume of distribution of valsartan is approximately 17 liters.
Protein BindingSacubitril: 94-97% bound to plasma proteins. Valsartan: 95% bound to serum proteins.
MetabolismSacubitril is metabolized by esterases to LBQ657; it does not undergo significant CYP450-mediated metabolism. Valsartan is minimally metabolized, with only about 20% of the dose recovered as metabolites.
Half-LifeThe elimination half-life of sacubitril is about 1.4 hours, and its active metabolite LBQ657 has a half-life of about 11.5 hours. Valsartan has an elimination half-life of about 6 hours.
ExcretionFollowing oral administration, sacubitril and its metabolites are primarily excreted in urine (about 52-68%) and feces (about 37-48%). Valsartan is mainly excreted in feces (about 83%) and urine (about 13%).
BioavailabilitySacubitril: at least 60%. Valsartan: approximately 23%.
Onset of ActionThe onset of blood pressure reduction is within 2-4 hours after oral administration.
Peak Plasma TimeSacubitril: 0.5 hours; LBQ657: 2 hours; Valsartan: 1.5-2 hours.
Duration of ActionThe blood pressure-lowering effect lasts for about 24 hours, allowing once-daily dosing.

How It Works

This medicine combines two active ingredients with complementary mechanisms. Sacubitril is a prodrug that is metabolized to LBQ657, which inhibits neprilysin, an enzyme responsible for degrading natriuretic peptides. This leads to increased levels of natriuretic peptides, which promote vasodilation, natriuresis, and diuresis, reducing blood pressure and cardiac workload. Valsartan is an angiotensin II receptor blocker (ARB) that selectively blocks the AT1 receptor, preventing the vasoconstrictor and aldosterone-secreting effects of angiotensin II. Together, these actions reduce vasoconstriction, sodium retention, and cardiac remodeling, improving cardiovascular outcomes in heart failure.

Mechanism Steps

1
Sacubitril metabolism: Sacubitril is a prodrug that is rapidly metabolized to its active metabolite, LBQ657.
2
Neprilysin inhibition: LBQ657 inhibits neprilysin, the enzyme that breaks down natriuretic peptides, bradykinin, and other vasoactive peptides.
3
Increased natriuretic peptides: Inhibition of neprilysin leads to higher levels of natriuretic peptides, which cause vasodilation, natriuresis, and diuresis.
4
Valsartan action: Valsartan blocks the AT1 receptor, preventing angiotensin II from causing vasoconstriction and aldosterone release.
5
Combined effect: The dual mechanism reduces blood pressure, decreases cardiac workload, and slows heart failure progression.

💡 How to Take azmarda 50mg tablet

Strength: Each tablet contains sacubitril 24 mg and valsartan 26 mg.

1Take this medicine orally with or without food.
2Swallow the tablet whole with a glass of water.
3Take it at the same times each day, approximately 12 hours apart.
4Do not crush, chew, or split the tablet unless advised by your doctor.
5If you miss a dose, follow the missed dose instructions.
6Do not stop taking this medicine without consulting your doctor.

Dosage Information

Adult DosageThe recommended starting dose of this medicine is 50 mg (sacubitril 24 mg + valsartan 26 mg) taken orally twice daily. After 2-4 weeks, the dose is typically increased to 100 mg (sacubitril 49 mg + valsartan 51 mg) twice daily, and then to the target dose of 200 mg (sacubitril 97 mg + valsartan 103 mg) twice daily as tolerated. Dose must be individualized by a qualified clinician based on indication, age, weight, renal and hepatic function, and blood pressure.
Pediatric DosagePediatric dosing is not established from available information. Consult a pediatrician.
Elderly DosageNo dose adjustment is required based on age alone. However, elderly patients may be more sensitive to the blood pressure-lowering effects. Monitor blood pressure and renal function closely.
Renal ImpairmentFor patients with mild to moderate renal impairment (eGFR ≥30 mL/min/1.73 m²), no dose adjustment is needed. For severe renal impairment (eGFR <30 mL/min/1.73 m²), the starting dose should be reduced to 50 mg twice daily, and the dose should be titrated slowly. Use with caution.
Hepatic ImpairmentFor patients with mild to moderate hepatic impairment (Child-Pugh A or B), no dose adjustment is required. This medicine is not recommended in patients with severe hepatic impairment (Child-Pugh C).
Maximum Daily DoseThe maximum recommended dose is 200 mg (sacubitril 97 mg + valsartan 103 mg) twice daily, totaling 400 mg per day.

Dosage Timeline

🌅 Morning ❌ ☀️ Afternoon ❌ 🌆 Evening ❌ 🌙 Night ❌

🍽️ Food Timing Guide

With or without food
Take consistently
Food does not significantly affect absorption.
High-potassium foods
Moderate intake
May increase potassium levels.
Salt substitutes with potassium
Avoid
Can cause dangerous hyperkalemia.

⏰ What to Do If You Miss a Dose

📌 Less than 6 hours since missed dose
→ Take the missed dose as soon as you remember.
💡 Continue with the regular schedule.
📌 More than 6 hours since missed dose
→ Skip the missed dose.
💡 Do not double dose to catch up.

⚠️ Side Effects of azmarda 50mg tablet

✅ Common Side Effects

Dizziness (Common (5-10%))
Rise slowly from sitting or lying position. Avoid driving if dizzy. Consult doctor if persistent.
Low blood pressure (hypotension) (Common (5-10%))
Stay hydrated. If you feel faint, lie down and call your doctor.
Cough (Common (5-10%))
Usually dry and harmless. If it bothers you, consult your doctor.
Hyperkalemia (high potassium) (Common (5-10%))
Your doctor will monitor potassium levels. Avoid potassium supplements unless prescribed.
Kidney problems (Common (5-10%))
Regular blood tests are needed. Report decreased urine output or swelling.

🚨 Serious Side Effects

Angioedema (Rare (<0.1%))
Seek emergency medical attention if you experience swelling of face, lips, throat, or tongue, or difficulty breathing.
Severe hypotension (Uncommon (0.1-1%))
If you experience fainting or severe dizziness, lie down and call your doctor immediately.
Worsening renal function (Uncommon (0.1-1%))
Report decreased urine output, swelling in legs, or fatigue. Your doctor will monitor kidney function.

⚠️ Rare Side Effects

Anaphylaxis
Seek emergency medical help immediately if you experience rash, itching, difficulty breathing, or swelling.
Severe hyperkalemia
Seek medical attention if you experience muscle weakness, irregular heartbeat, or paralysis.

Consult your doctor if you experience any unusual symptoms.

🔬 Drug Interactions

Drug Severity Effect
ACE inhibitors Major
Aliskiren Major
Potassium-sparing diuretics Major
NSAIDs Moderate
Lithium Major
Statins Moderate
Metformin Moderate
Antacids Minor

🚨 Major Interactions

  • ACE inhibitors (e.g., enalapril, lisinopril)
  • Aliskiren
  • Potassium-sparing diuretics (e.g., spironolactone, triamterene)
  • NSAIDs (e.g., ibuprofen, naproxen)
  • Lithium

⚡ Moderate Interactions

  • Statins (e.g., atorvastatin)
  • Metformin

🍷 Alcohol Interaction

Alcohol may enhance the blood pressure-lowering effect of this medicine, leading to dizziness or fainting. It is advisable to limit or avoid alcohol while taking this medicine.

🔎 Check Your Other Medicines

Educational tool. Always confirm with your doctor or pharmacist.

🛡️ Safety & Warnings

🚫 Contraindications

["History of angioedema related to ACE inhibitor or ARB therapy","Concomitant use with ACE inhibitors","Concomitant use with aliskiren in patients with diabetes","Pregnancy","Severe hepatic impairment","Hypersensitivity to sacubitril, valsartan, or any component of the formulation"]

⚠️ Warnings & Precautions

["Angioedema: May cause angioedema, which can be life-threatening. Discontinue immediately if suspected.","Hypotension: May cause symptomatic hypotension, especially in volume-depleted patients. Correct volume depletion before starting.","Renal impairment: May worsen kidney function. Monitor renal function regularly.","Hyperkalemia: May cause high potassium levels. Monitor potassium, especially in patients with renal impairment or diabetes.","Fetal toxicity: Contraindicated in pregnancy. Can cause fetal harm."]

🤱 Lactation Safety

It is not known whether this medicine is excreted in human breast milk. Because of the potential for serious adverse reactions in breastfed infants, a decision should be made whether to discontinue nursing or discontinue the medicine, taking into account the importance of the medicine to the mother.

💊 Overdose Management

Limited data are available on overdose with this medicine. In case of overdose, symptomatic and supportive treatment should be initiated. If the patient is hypotensive, place them in a supine position and consider intravenous fluids. Hemodialysis is unlikely to be effective in removing sacubitril or valsartan due to high protein binding.

⏰ Missed Dose

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose to catch up.

Additional Safety Advice

General Safety

This medicine should only be taken as prescribed by your doctor. Do not change the dose or stop taking it without consulting your healthcare provider. Avoid using potassium supplements or salt substitutes containing potassium unless directed by your doctor. Inform your doctor if you are pregnant, planning to become pregnant, or breastfeeding. This medicine can cause dizziness; avoid driving or operating heavy machinery until you know how it affects you. Keep all appointments for blood tests to monitor kidney function and potassium levels. Do not take this medicine with ACE inhibitors or aliskiren if you have diabetes. Store at room temperature away from moisture and heat.

👴 Special Considerations for Elderly

💡 For Patients Above 65

Elderly patients may be more sensitive to the blood pressure-lowering effects of this medicine. Start with a low dose and titrate slowly. Monitor renal function and potassium levels closely.

🤰 Pregnancy Planning (TTC)

This medicine is contraindicated during pregnancy. Women of childbearing potential should use effective contraception. If you are planning pregnancy, consult your doctor to switch to a safer alternative before conception.

🏥 Post-Surgery Considerations

Inform your surgeon and anesthesiologist that you are taking this medicine. It may need to be temporarily stopped before surgery due to its blood pressure-lowering effects. Follow your doctor's instructions regarding when to resume.

🦷 Dental Procedures

Inform your dentist that you are taking this medicine, as it may cause dizziness or low blood pressure during dental procedures. Your dentist may take precautions such as monitoring your blood pressure.

💚 Lifestyle Tips for Better Results

🏃
Maintain a healthy weight to reduce strain on your heart.
🥗
Follow a low-sodium diet to manage blood pressure and fluid retention.
😴
Engage in regular, moderate exercise as advised by your doctor.
💧
Avoid smoking and limit alcohol consumption.
🧘
Get adequate sleep and manage stress through relaxation techniques.
🌞
Monitor your weight daily and report sudden increases to your doctor.

🏋️ Exercise Considerations

Moderate exercise is generally safe and beneficial, but avoid strenuous activities that cause severe breathlessness or dizziness. Always warm up and cool down. If you experience chest pain, severe shortness of breath, or palpitations, stop and seek medical attention.

🥗 Diet Recommendations

Limit sodium intake to less than 2 grams per day.
Avoid high-potassium foods if your potassium levels are high.
Include plenty of fruits, vegetables, and whole grains.
Choose lean proteins and healthy fats.
Stay well hydrated unless fluid restriction is advised.

💼 Impact on Daily Work & Life

This medicine may cause dizziness or fatigue, which can affect your ability to drive or operate machinery. Avoid these activities until you know how the medicine affects you. Most patients can continue their normal work with some adjustments.

🛑 When to Stop This Medicine

Do not stop taking this medicine without consulting your doctor. If you experience serious side effects like angioedema, severe hypotension, or worsening kidney function, your doctor may advise stopping or adjusting the dose. Always seek medical advice before discontinuing.

📅 Long-Term Use Effects

Long-term use of this medicine has been shown to improve survival and reduce hospitalizations in heart failure patients. However, it requires regular monitoring of kidney function, potassium levels, and blood pressure. Some patients may develop tolerance or experience persistent side effects. Regular follow-up with your doctor is essential to adjust the dose and manage any complications.

🌿 Non-Medicine Approaches

These can complement medicine but do not replace prescribed treatment.

ACE inhibitors

Alternative class of heart failure medicines, but may cause cough.

Evidence: Well-established
ARBs

Similar to valsartan alone, used if ARNI is not tolerated.

Evidence: Well-established
Beta-blockers

Often used in combination with ARNI for heart failure.

Evidence: Well-established

💉 Vaccination Considerations

💉 If You're Getting Vaccinated

There are no specific vaccine interactions with this medicine. However, patients with heart failure should receive annual influenza and pneumococcal vaccinations as recommended by their doctor.

📦 Storage Guide

✅ DO

Store at room temperature (15-30°C)

❌ DON'T

Do not refrigerate or freeze

✅ DO

Keep in original container

❌ DON'T

Do not transfer to unmarked containers

✅ DO

Keep away from direct sunlight and moisture

❌ DON'T

Do not store in bathroom cabinet

✈️ Traveling with This Medicine

When traveling, carry this medicine in its original packaging along with a copy of your prescription. Keep it in your carry-on luggage to avoid loss. Store at room temperature and protect from moisture. If crossing time zones, adjust dosing times gradually, but maintain approximately 12-hour intervals between doses. Consult your doctor before traveling if you have any concerns.

💰 Cost Analysis & Savings

👥 Real Patient Stories

Educational, anonymized scenarios. Individual results may vary.

👤 A 60-year-old man with heart failure and reduced ejection fraction
He was started on this medicine after his doctor switched him from an ACE inhibitor. Within a few weeks, he noticed he could walk further without getting breathless. He had some dizziness initially, which improved as his body adjusted. He emphasized the importance of taking it regularly and monitoring his blood pressure.
💡 Lesson: This medicine can significantly improve symptoms of heart failure, but it requires regular monitoring and adherence.
👤 A 55-year-old woman with heart failure and diabetes
She was prescribed this medicine along with other heart failure medications. She experienced mild cough and dizziness, but these were manageable. Her doctor monitored her kidney function and potassium levels regularly. She found that taking the medicine with food helped reduce stomach upset.
💡 Lesson: Taking this medicine with food can improve tolerability, and regular monitoring is essential for safety.

💬 Questions Patients Often Ask

Q: How long does it take to work?

A: This medicine starts working within hours to lower blood pressure, but improvement in heart failure symptoms may take several weeks.

Q: Can I take this medicine with food?

A: Yes, this medicine can be taken with or without food.

Q: What should I do if I miss a dose?

A: If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose.

Q: Is this medicine safe during pregnancy?

A: No, this medicine is contraindicated during pregnancy as it can harm the fetus. Use effective contraception while taking this medicine.

Q: Can I stop taking this medicine suddenly?

A: No, do not stop taking this medicine without consulting your doctor. Stopping suddenly can worsen heart failure.

🤔 Common Patient Concerns

💭 These are the concerns patients most commonly raise

  • Can I take this medicine long-term?
  • Will it affect my kidney function?
  • Can I drive after taking this medicine?
  • Does it interact with my blood pressure medicine?
  • What if I miss a dose?
  • Can I drink alcohol while taking this?

🔄 Substitutes for azmarda 50mg tablet

View All

Alternative brands with exact same active ingredient:

Medical Note: Always consult your doctor before switching medications.

🛑 Myths vs. Facts

  • Myth: This medicine can cure heart failure.
    Fact: This medicine does not cure heart failure but helps manage symptoms and improves survival.
  • Myth: This medicine can be taken with any other blood pressure medicine.
    Fact: It should not be taken with ACE inhibitors or aliskiren due to risk of serious interactions.
  • Myth: This medicine is safe during pregnancy.
    Fact: This medicine is contraindicated during pregnancy as it can harm the fetus.

🔄 Alternative Options

Brand Alternatives

📊 Comparison with Similar Medicines

[{"medicine":"This medicine","class":"ARNI","primary_use":"HFrEF","route":"Oral","frequency":"Twice daily"},{"medicine":"Valsartan","class":"ARB","primary_use":"Hypertension, HF","route":"Oral","frequency":"Once or twice daily"},{"medicine":"Enalapril","class":"ACE inhibitor","primary_use":"Hypertension, HF","route":"Oral","frequency":"Once or twice daily"}]

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