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Entresto
Entresto (sacubitril/valsartan) is a combination medication used to treat heart failure. It belongs to a class of drugs called angiotensin receptor-neprilysin inhibitors (ARNI). Entresto helps manage chronic heart failure by relaxing blood vessels, reducing sodium retention, and decreasing strain on the heart. It improves heart function and reduces the risk of hospitalization due to heart failure.
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Frequently Asked Questions
How long does it take for Entresto to work?
Entresto may start improving heart function within 2 weeks, but it may take longer for patients to experience full benefits.
Can I take Entresto if I have kidney problems?
Entresto can be used in patients with kidney disease, but kidney function should be closely monitored, and dose adjustments may be necessary.
Can Entresto cause a cough?
Yes, Entresto may cause a cough, though less frequently than ACE inhibitors.
What should I do if I miss a dose?
If you miss a dose, take it as soon as you remember. If it’s close to your next dose, skip the missed dose and continue with your regular dosing schedule. Do not double up doses.
Can Entresto be taken with other heart failure medications?
Yes, Entresto is often taken alongside other heart failure medications like beta-blockers or diuretics. Always consult your doctor about combining medications.
Comprehensive Drug Guide
How Does Entresto Work?
Entresto combines valsartan, an angiotensin receptor blocker (ARB), with sacubitril, a neprilysin inhibitor. Valsartan helps relax blood vessels, while sacubitril increases the levels of peptides that help dilate blood vessels and reduce sodium and fluid retention. Together, these actions decrease strain on the heart, improve heart function, and help manage heart failure symptoms.
Common Dosages
- 24 mg sacubitril/26 mg valsartan
- 49 mg sacubitril/51 mg valsartan
- 97 mg sacubitril/103 mg valsartan
Typical Dosing
- The typical starting dose of Entresto is 49 mg/51 mg taken twice daily, which may be adjusted based on response and tolerance. In some cases, a lower dose may be initiated for patients not previously on an ARB or those with low blood pressure.
Typical Dosing
FDA Approved Indications
- Treatment of chronic heart failure in patients with reduced ejection fraction (HFrEF).
Who Shouldn't Take Entresto?
- Known hypersensitivity to sacubitril, valsartan, or any of the components
- History of angioedema related to ACE inhibitors or ARBs
- Use with ACE inhibitors (must be discontinued 36 hours prior)
Advice From The Pharmacist
- Take Entresto at the same time each day, with or without food.
- Avoid taking Entresto with ACE inhibitors or aliskiren.
- Monitor your blood pressure regularly, as Entresto can cause hypotension (low blood pressure).
Side Effects of Entresto
Common Side Effects
- Low blood pressure (hypotension)
- Cough
- Dizziness
- Kidney problems
Uncommon/Severe Side Effects
- Angioedema (swelling of the face, lips, or tongue)
- Worsening kidney function
- High blood levels of potassium (hyperkalemia)
Risks and Warnings of Entresto
- Angioedema Risk: Entresto can cause angioedema, especially in patients with a history of this condition. Discontinue use immediately if swelling occurs.
- Kidney Function: Entresto may worsen kidney function in some patients. Regular monitoring of kidney function is recommended.
Interactions with Entresto
Common Drug Interactions
- ACE inhibitors: Should not be used with Entresto. Stop ACE inhibitors at least 36 hours before starting Entresto.
- Potassium supplements or salt substitutes: These may increase the risk of hyperkalemia (high potassium levels).
Alternatives to Entresto
- Losartan (an ARB often used in heart failure management)
- Lisinopril (an ACE inhibitor used in heart failure)
- Carvedilol (a beta-blocker commonly prescribed for heart failure)
