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Xinchuotuo (sacubitril + allisartan calcium, also known as S086) is a drug-drug cocrystal and angiotensin receptor-neprilysin inhibitor (ARNI) developed by Shenzhen Salubris Pharmaceuticals. It is composed of sacubitril (a neprilysin inhibitor prodrug) and EXP3174 (the active metabolite of the angiotensin II receptor blocker allisartan isoproxil) in a 1:1 molar ratio, coordinated with calcium ions. Xinchuotuo was approved by the NMPA in China in May 2025 for the treatment of primary (essential) hypertension and is in Phase III clinical development for chronic heart failure, specifically heart failure with reduced ejection fraction (HFrEF). By simultaneously inhibiting neprilysin (via its active metabolite LBQ657) and blocking the angiotensin II type 1 (AT1) receptor (via EXP3174), the drug promotes vasodilation, natriuresis, and diuresis while preventing vasoconstriction and aldosterone-mediated effects, thereby effectively lowering blood pressure and protecting target organs.
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