Does Entresto lower blood pressure?

Entresto (sacubitril/valsartan) is a prescription medication used to reduce the risk of cardiovascular death and hospitalization in adult patients with chronic heart failure. It is also used to treat heart failure in pediatric patients 1 year of age and older.

Here we will take a look at what Entresto is, what it’s used for, how to take it, how it works, its side effects, and some commonly asked questions about it.

What is Entresto used for?

Entresto (sacubitril/valsartan) is a prescription angiotensin receptor neprilysin inhibitor (ARNI) manufactured by Novartis Pharmaceuticals. It is approved by the U.S. Food and Drug Administration (FDA):

  • To reduce the risk of cardiovascular death and hospitalization for heart failure with reduced ejection fraction (HFrEF) in adult patients with chronic heart failure. It is more beneficial in patients with left ventricular ejection fraction (LVEF) that is below normal
  • For the treatment of symptomatic heart failure with left ventricular systolic dysfunction in pediatric patients 1 year of age and older

How to take Entresto

  • Take Entresto exactly as your healthcare provider prescribes it
  • Entresto’s usual starting dose is 49 mg/51 mg taken twice a day. Your doctor may start you on a lower starting dose or change your dose during treatment
  • If your child can’t swallow tablets, your pharmacist may be able to prepare Entresto as a liquid suspension at the recommended tablet dosage. Please note the suspension will also contain Ora-Sweet SF and Ora-Plus. Shake the suspension well before each use
  • If you miss a dose of Entresto, take it immediately. If it is close to your next dose, do not take the missed dose. Take the next dose at your regular time
  • If you take too much Entresto, call your healthcare provider right away or go to the nearest emergency room
  • Discontinue Entresto as soon as possible when pregnancy is detected
  • It is not known if Entresto passes into your breast milk. Consult your healthcare provider before breastfeeding
  • Read the prescribing information and the Instructions for Use and Medication Guide, including the Boxed Warning that comes with your Entresto prescription

What are the side effects of Entresto?

Some common side effects of Entresto in clinical trials can include:

  • Hypotension
  • Hyperkalemia
  • Cough
  • Dizziness
  • Lightheadedness

Some serious side effects of Entresto include:

  • Angioedema
  • Worsening kidney function, especially in those with congestive heart failure (CHF)
  • Angioedema (swelling of your face, lips, tongue, and throat) and hypotension (low blood pressure)
  • Severe allergic reactions – discontinue Entresto immediately and seek medical advice if you have symptoms such as hives, trouble breathing, or swelling of your face, lips, tongue, or throat
  • Increase in potassium levels. Before using potassium supplements or salt substitutes that contain potassium, consult your healthcare provider

You can report any side effects you experience to the FDA at 1-800-FDA-1088 or

Precautions with Entresto

Entresto is contraindicated if you have any of the following medical conditions:

  • Pregnancy – Entresto may harm or cause death to your unborn baby
  • Hypersensitivity to any of the active ingredients of Entresto
  • History of angioedema related to previous angiotensin-converting enzyme inhibitors (ACE inhibitors) or ARBs
  • Hereditary angioedema
  • Do not take Entresto within 36 hours of ACE inhibitors such as lisinopril or ramipril
  • Concomitant use with Tekturna (aliskiren) in patients with diabetes
  • Severe liver problems or liver disease

How quickly does Entresto lower blood pressure?

Entresto will take 30 minutes to 2 hours to reach peak levels, with steady plasma levels maintained after 3 days. When Entresto actually starts to work will however be different for each individual.

Can Entresto lower your blood pressure too much?

Overdose of Entresto will cause side effects such as hypotension, making you feel very lightheaded, dizzy, or tired.

What medications are similar to Entresto?

There are other medications to treat heart failure that your healthcare professional can prescribe if Entresto is not the right medication for you. Some FDA-approved alternative treatment options include:

  • Beta-blockers such as carvedilol, metoprolol, and bisoprolol can slow your heart rate and reduce high blood pressure
  • ACE inhibitors to help blood vessels relax and open
  • ARBs such as valsartan and losartan also cause blood vessels to relax and open
  • Neprilysin inhibitors increase the availability of natriuretic peptides helping to dilate blood vessels

Diuretics will help with some heart failure symptoms, but not necessarily improve your heart’s ejection fraction

What medications should not be taken with Entresto?

When Entresto is taken with other medications, they may interact and change how they work. It may also increase the severity of certain side effects or make them more likely to occur. Make sure your doctor is aware of all the medications you take, including prescription drugs, over-the-counter medications, vitamins, and herbal supplements. Some major drug interactions with Entresto include:

  • Aliskiren – avoid use if you have an eGFR < 60
  • Potassium-sparing diuretics (water pills) – can cause hyperkalemia (high potassium levels)
  • Non-steroidal anti-inflammatory drugs (NSAIDs) – meds such as ibuprofen can increase your risk of kidney problems
  • Lithium – may cause lithium toxicity

Does Entresto improve ejection fraction?

Yes. Improvements in ejection fraction are seen between 6 to 12 months of treatment with Entresto.

How long does Entresto extend life?

Patients with reduced ejection fraction taking Entresto have an expected extended life expectancy of 1.5 to 2 years compared to patients treated with enalapril.

What are the dangers of Entresto?

Entresto may cause side effects, some more serious than others. Side effects may include high blood potassium, low blood pressure, or severe kidney problems. Speak to your doctor for medical advice if you experience any side effects.

Can you take carvedilol and Entresto at the same time?

Yes. Carvedilol is classed as a beta-blocker and is commonly used in combination with Entresto.

Does Entresto lower heart rate?

No. Entresto may cause high potassium levels and cause side effects such as chest pain, irregular heartbeat, increased heart rate, nausea, vomiting, or diarrhea.

How long does it take for Entresto to work?

Entresto reaches steady plasma concentrations in the body in 3 days. When it actually starts to work will be different for each individual.

Will Entresto cause dizziness?

Dizziness is a common side effect of Entresto. Speak to your doctor for medical advice if you have this side effect.

Does Entresto make you tired?

Entresto may make you feel light-headed, or faint, or cause you to feel extreme tiredness. Speak to your healthcare provider for medical advice if you have this side effect.

Medically reviewed

A medical professional has reviewed this article.

Jamie Winn, PharmD
Jamie Winn, PharmD

Jamie Winn, PharmD

Medical Writer & Reviewer

Jamie Winn, PharmD

Medical Writer & Reviewer

Dr. Jamie Winn received his Doctor of Pharmacy in 2002 from the University of South Carolina College of Pharmacy, Columbia, SC. Jamie is a medical reviewer for NiceRx.

Share this page

Other articles on

Sources (4)

  1. - Entresto

  2. National library of medicine - Sacubitril/Valsartan

  3. Medscape - sacubitril/valsartan (Rx)

  4. FDA - highlights of prescribing information for Entresto

The content on this website is intended for information purposes only. It does not constitute medical advice. The information on this website should not be relied upon and is not a substitute for professional medical advice. You should always speak to your doctor regarding the risks and benefits of any treatment.