Nitrosamines can be formed through various chemical processes, including the reaction between nitrites and secondary amines in certain conditions. It is a N-Nitroso of secondary amine present in Sacubitril. Nitrosamines are part of a broader class of compounds known as N-nitroso compounds.
Chemically, sacubitril is the prodrug form of sacubitrilat, the active neprilysin inhibitor. The chemical name for sacubitrilat is (2S,4S)-2-ethoxy-4-{[(3S)-3-methyl-4-(methylamino)-4-oxopentanoyl]amino}-5-propan-2-yl-5H-imidazo[4,5-d]pyridazin-1-one. Sacubitril/valsartan is a combination medication used in the treatment of heart failure with reduced ejection fraction (HFrEF). Sacubitril inhibits neprilysin, an enzyme that breaks down natriuretic peptides involved in cardiovascular homeostasis. This inhibition leads to increased levels of natriuretic peptides, promoting vasodilation and natriuresis. Valsartan, an angiotensin receptor blocker, complements this action by blocking the vasoconstrictor effects of the renin-angiotensin-aldosterone system. The combined effect of sacubitril/valsartan helps improve cardiac function, reduce symptoms, and enhance outcomes in patients with HFrEF.
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