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EspañolEntresto overview
BRAND NAMES:
Entresto
Generic Names:
Sacubitril/valsartan
Uses:
Treats heart failure
Therapeutic Classes:
Angiotensin receptor neprilysin inhibitor (ARNI)
Forms:
Tablet
How it’s taken:
By mouth
What is Entresto used for?
Entresto is FDA approved to treat chronic heart failure in adults and children. Specifically, Entresto is beneficial for those who have heart failure with reduced ejection fraction, meaning the heart muscle does not contract effectively and does not pump blood adequately. It can help reduce the risk of hospital visits and death caused by heart failure. Sacubitril increases the levels of proteins that can dilate blood vessels, which helps to lower blood pressure and reduce strain on the heart. Valsartan blocks the action of angiotensin II, a substance in the body that can narrow blood vessels and worsen heart failure.
Entresto is a brand-name drug containing a combination of sacubitril and valsartan. It is approved to treat certain types of heart failure and may help reduce the risk of death and hospitalization. It works by relaxing blood vessels and improving the ability of the heart to pump blood.
While taking Entresto, patients may experience side effects such as cough, high blood potassium levels, or kidney problems. Periodic blood tests are often needed to monitor the effectiveness and safety of the drug. Unusual symptoms should be reported to a healthcare provider.
Entresto can interact with certain drugs like ACE inhibitors or aliskiren, increasing the risk of side effects. Patients should inform their healthcare provider about all other medications they are taking to prevent potential drug interactions.
The correct dosage of Entresto may vary depending on the condition being treated and response to treatment. Patients should take Entresto according to their healthcare provider's instructions and not adjust the dose on their own.
What form(s) does Entresto come in
Tablet
24/26 mg
49/51 mg
97/103 mg
What are common Entresto doses?
Adults typically start with 49/51 mg, taken orally twice daily.
Depending on the patient's tolerance, the dose may be doubled after 2 to 4 weeks to 97/103 mg twice daily.
For children aged one year and older, the dosage varies based on body weight and age. The pediatric dosage may be gradually increased every two weeks to a target maintenance dose, as tolerated.
Common Entresto prescriptions
Entresto
24-26mg tabletEntresto
49-51mg tabletEntresto
97-103mg tablet
How to take Entresto
Take Entresto at the same time each day to establish a routine.
Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.
Read and follow the patient instructions that come with this medicine. Talk to your doctor or pharmacist if you have any questions.
Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
What to do if you miss a dose of Entresto
Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
If you're unsure when to take the next dose, consult your healthcare provider.
Entresto contraindications
This medicine is not right for everyone. Do not take Entresto if you're allergic to sacubitril, valsartan, or any ingredients in the medication.
If you have hereditary angioedema or you've had episodes of angioedema related to previous treatment with angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs), Entresto should be avoided.
If you've taken an ACE inhibitor recently, typically within 36 hours, you should not start Entresto.
Those with diabetes or kidney problems who are also taking the drug aliskiren should not use Entresto.
Pregnant women should avoid Entresto, as it may cause harm to an unborn baby, particularly in the second and third trimesters.
Entresto warnings
Keep all medicine out of the reach of children. Never share your medicine with anyone.
Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
It is not safe to take this medicine during pregnancy. It could harm an unborn baby. Tell your doctor right away if you become pregnant.
Tell your doctor if you are breastfeeding or if you have kidney disease, liver disease, or diabetes.
This medicine may affect the function of your kidneys. You may need to discontinue Entresto or take a lower dose if you experience kidney function test abnormalities.
You may experience high potassium levels (hyperkalemia), which may require monitoring due to potential heart and other health risks.
This medicine could lower your blood pressure too much, especially when you first use it or if you also take water pills or diuretics. Monitor for symptoms of low blood pressure, such as dizziness or fainting, while taking this medication.
There's a risk of angioedema (rapid swelling under the skin), particularly in patients with a history of the condition. The risk may also be higher in people who are African American.
Serious allergic reactions are possible. Seek immediate medical attention if you experience a serious rash, swelling of the face or throat, or trouble breathing.
Entresto interactions
Do not take this medicine with aliskiren if you have diabetes.
Do not take this medicine together with an ACE inhibitor medicine or within 36 hours after you have taken an ACE inhibitor.
Taking Entresto with lithium may increase the levels of lithium in the blood, increasing the risk of lithium toxicity. Lithium levels may need to be monitored while taking Entresto at the same time.
Combining Entresto and nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen, and diclofenac, may lead to kidney problems, including reduced kidney function and possible kidney failure.
Taking Entresto with potassium-sparing diuretics, such as triamterene and spironolactone, may lead to high levels of potassium in the blood.
Ask your doctor before you use any medicine, supplement, or salt substitute that contains potassium.
Entresto side effects
Entresto is associated with various side effects, which can differ among individuals. Not everyone taking Entresto will experience these side effects, and some people may not notice any adverse reactions.
Less serious side effects
Cough
Dizziness
Serious side effects
High potassium levels, which may cause symptoms like confusion, weakness, uneven heartbeat, trouble breathing, and numbness in your hands, feet, or lips
Low blood pressure, which may cause symptoms of lightheadedness, dizziness, or fainting
Kidney problems, with signs such as a decrease in how much or how often you urinate, bloody or cloudy urine, and lower back or side pain
Allergic reactions, with symptoms such as itching or hives, swelling in the face or throat, chest tightness, and trouble breathing
Sources:
Entresto highlights of prescribing information, U.S. Food and Drug Administration (2021)
Sacubitril-valsartan, StatPearls (2022)
Entresto (sacubitril/valsartan): First-in-class angiotensin receptor neprilysin inhibitor fda approved for patients with heart failure, American Health and Drug Benefits (2015)