Final answer:
Discontinuing ACE inhibitors less than 36 hours before starting valsartan-sacubitril can lead to complications such as angioedema and hypertensive events due to elevated bradykinin levels. A washout period of at least 36 hours is essential to prevent these risks when transitioning medications.
Step-by-step explanation:
Complications of Discontinuing ACE Inhibitors before Starting Valsartan-Sacubitril
When transitioning from ACE inhibitors to valsartan-sacubitril, it is recommended to have a washout period of at least 36 hours. This is to prevent potential complications such as increased risk of angioedema. Angioedema is the rapid edema, or swelling, of the area beneath the skin or mucosa, and it occurs due to the accumulation of bradykinin. Bradykinin levels can become elevated when ACE inhibitors are not properly discontinued before initiating treatment with valsartan-sacubitril. The reason for this is that both drugs affect the renin-angiotensin-aldosterone system, but in different ways, leading to a higher likelihood of adverse effects if the transition period is not observed.
Error in not observing the washout period between these medications may result in increased bradykinin levels and potentially life-threatening hypertensive events. Therefore, medical professionals advise this gap period to mitigate such risks and ensure the safety of patients undergoing medication changes for heart failure or hypertension management.