<p><strong>Pediatric Use:&nbsp;</strong>Safety and effectiveness in pediatric patients have not been established.<br />
<br />
<strong>Geriatric Use:</strong>&nbsp;No relevant pharmacokinetic differences have been observed in elderly (&ge;65 years) or very elderly (&ge;75 years) patients compared to the overall population<br />
<br />
Renal Impairment:</p>

<ul>
	<li><strong>Severe</strong>: A starting dose of 24/26 mg twice-daily is recommended for patients with severe renal impairment (eGFR &lt;30 mL/min/1.73 m&sup2;). Double the dose of Sacubitril &amp; Valsartan every 2 to 4 weeks to the target maintenance dose of 97/103 mg twice daily, as tolerated by the patient.</li>
	<li><strong>Mild or moderate</strong>: No starting dose adjustment is needed for mild or moderate renal impairment.</li>
</ul>

<p>Hepatic Impairment:</p>

<ul>
	<li><strong>Moderate</strong>: A starting dose of 24/26 mg twice-daily is recommended for patients with moderate hepatic impairment (Child-Pugh B classification). Double the dose of Sacubitril &amp; Valsartan every 2 to 4 weeks to the target maintenance dose of 97/103 mg twice daily, as tolerated by the patient.</li>
	<li><strong>Mild</strong>: No starting dose adjustment is needed for mild hepatic impairment.</li>
	<li><strong>Severe</strong>: Use in patients with severe hepatic impairment is not recommended.</li>
</ul>