How long does it take Entresto to work?

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.

Learn more about how long it takes for Entresto to work, what it’s used for, how to take it, its side effects, and some commonly asked questions about it.

What is Entresto?

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.

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

Storage

• Store bottles of Entresto oral suspension at room temperature between 68°F to 77°F (20°C to 25°C) for up to 15 days. Do not refrigerate Entresto oral suspension
• Store Entresto tablets at room temperature between 68°F to 77°F (20°C to 25°C) away from moisture

How does Entresto work?

Entresto is a combination product that contains sacubitril and valsartan. Sacubitril acts as a neprilysin inhibitor. By blocking the enzyme neprilysin, sacubitril prevents the breakdown of natriuretic peptides which helps lower blood pressure. This also causes an accumulation of the protein angiotensin II.

Valsartan is an angiotensin II receptor blocker (ARB) that prevents angiotensin II from binding and causing vasoconstriction (narrowing of your blood vessels), and cardiac stimulation, among other blood pressure-raising effects. Valsartan is used along with sacubitril because it can block the effects of the accumulated angiotensin II.

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 disease or function, especially in those with congestive heart failure (CHF)
• Angioedema (swelling of your face, lips, tongue, and throat) and hypotension (low blood pressure)
• 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 www.fda.gov/medwatch.

What dosage is recommended for Entresto?

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. Your exact dose will be based on your age, weight, and the condition you are being treated for.

What happens if I take too much Entresto?

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

Precautions with Entresto

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

• Pregnancy
• Hypersensitivity to any components 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 disease

What other medications interact 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

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

How can I stay healthy while taking Entresto?

Exercise and a healthy balanced diet are recommended while taking Entresto.

What does the drug cost?

Entresto prices will vary depending on the amount you buy and where you buy it from. As a guide, a pack of 60, 24-26 mg Entresto tablets will cost between $620 and $700.

What time of day should Entresto be taken?

Entresto tablets should be taken with or without food in the morning and evening at the same time each day.

How long does Entresto stay in the body?

The active form of sacubitril is 50% eliminated from your body after about 12 hours. Valsartan is 50% eliminated from your body after about 10 hours of taking the Entresto tablet.

How long does it take Entresto to work?

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

Can Entresto reverse heart failure?

Entresto has been shown to reduce the risk of cardiovascular death or hospitalization for heart failure by 20% after more than 2 years.

How long does it take Entresto to improve heart function?

Improvements in heart function are seen after 12 months of treatment with Entresto.

Does Entresto make you feel better?

Less than 40% of patients described feeling better while taking Entresto. Over 50% of patients reported a negative experience while using 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.

How long does it take for Entresto to improve ejection fraction?

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

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 Entresto be taken once a day?

Entresto is recommended to be taken twice daily.

What happens if you suddenly stop taking Entresto?

Do not suddenly stop taking Entresto unless your doctor tells you to. Stopping treatment may cause your condition to get worse.

Does Entresto make you tired?

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

Does Entresto cause weight gain?

Entresto does not cause weight gain. If you have rapid weight changes it may be that your heart failure is getting worse. Speak to your doctor if you experience rapid weight gain while taking Entresto.