Entresto (Sacubitril/Valsartan)

Entresto (sacubitril/valsartan) is a medication used to treat heart failure in adults and children. It combines two drugs that work together to help the heart pump more effectively. Sacubitril helps blood vessels relax by stopping the breakdown of natural substances in the body that widen the vessels. Valsartan helps prevent blood vessels from tightening, allowing blood to flow more easily. Together, these effects help reduce stress on the heart and reduce the risk of hospitalization or death in people with heart failure.

Directions

Entresto is taken by mouth twice daily, with or without food. The standard starting dose for adults with chronic heart failure is typically 49/51 mg (sacubitril/valsartan) twice daily, though some patients may begin at 24/26 mg twice daily. The dose can be doubled every 2 to 4 weeks as tolerated, with a target maintenance dose of 97/103 mg twice daily. In children, the dosage will depend on body weight.

It's important to take this medication at the same time each day. Do not stop taking Entresto without consulting a doctor.

Ingredients

The active ingredients in Entresto are sacubitril and valsarta

Cautions

• Before using this medication, you may want to consult a healthcare provider about the following:
  • Any existing health conditions
  • Any allergies
  • A list of all medications currently being taken
• Entresto can cause serious harm to an unborn baby if taken during pregnancy, especially in the second or third trimester. If you become pregnant while taking Entresto, your healthcare provider will usually stop the medication and switch you to a safer option.
• Entresto can cause angioedema, which is sudden swelling of the face, lips, tongue, or throat that can be life-threatening. If swelling affects breathing or swallowing, emergency medical care is needed and the medication should never be restarted.
• People who have had angioedema before, especially from ACE inhibitors or ARBs, should not take Entresto. The risk of angioedema is higher in Black patients and in those with hereditary angioedema.
• Entresto lowers blood pressure and may cause dizziness, lightheadedness, or fainting, especially when starting treatment or if you are dehydrated. Your provider may adjust your dose or other blood pressure medicines if symptoms occur.
• Entresto can affect kidney function, particularly in people with heart failure, kidney disease, or narrowed kidney arteries. Blood tests are used to monitor kidney health, and the dose may be adjusted if kidney function worsens.
• Entresto may raise potassium levels in the blood, which can affect heart rhythm if levels become too high. Regular blood tests are important, especially if you have kidney disease, diabetes, or follow a high-potassium diet.

Contraindications

Avoid taking or using this medication if any of the following apply:

• Hypersensitivity to sacubitril, valsartan, or any other ingredient of Entresto
• History of angioedema related to previous ACE inhibitor or ARB medications
• Combined use with ACE inhibitors (Do not take Entresto with or within 36 hours of switching to or from an ACE inhibitor)
• Combined use with aliskiren in people with diabetes
• Pregnancy, as it can cause fetal harm or death when administered during the second or third trimester

Side Effects

Common side effects of Entresto include:

• Low blood pressure (hypotension)
• Dizziness or lightheadedness
• Cough
• Increased potassium levels in the blood (hyperkalemia)
• Changes in kidney function

These side effects are more common when starting treatment or adjusting the dose. Blood tests may be done regularly to monitor kidney function and potassium levels while on Entresto.

More serious side effects can occur, including angioedema, a severe allergic reaction that causes swelling of the face, lips, tongue, or throat and can be life-threatening. Kidney problems may worsen in some people and, in rare cases, lead to kidney failure. Seek immediate medical attention for trouble breathing, facial swelling, severe dizziness, or fainting.