Entresto Dosage, forms & strengths
Complete a free online enrollment application to find out if you’re eligible to pay only $49 per month for your Entresto medication.
Get started todayEntresto (sacubitril/valsartan) is a prescription angiotensin receptor neprilysin inhibitor (ARNI) that is manufactured by Novartis Pharmaceuticals. It is a combination of an angiotensin II receptor blocker (ARB) valsartan and a neprilysin inhibitor sacubitril.
Entresto is approved by the U.S. Food and Drug Administration (FDA):
- to reduce the risk of cardiovascular death and hospitalization for heart failure in adult patients with chronic heart failure, especially 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 aged 1 year and older.
Entresto forms and strengths
Entresto is available as a film-coated tablet in the following strengths:
- 24mg/26 mg tablet
- 49mg/51 mg tablet
- 97mg/103 mg tablet
Entresto dosage for adults
The recommended starting dose of Entresto is 49mg/51mg twice daily. The starting dose will be reduced to half for:
- Patients not currently taking an ACE inhibitor or ARB or previously taking a low dose of these medications
- Patients with severe renal impairment
- Patients with moderate liver impairment
Adult patients will have their doses adjusted every 2 to 4 weeks and pediatric doses every 2 weeks as tolerated.
Entresto adult dosage chart
| Indication | Starting dosage | Standard dosage | Maximum dosage |
|---|---|---|---|
| Heart failure | 49mg/51mg twice a day. | 97mg/103mg twice a day. | 97mg/103mg twice a day. |
Entresto pediatric dosage chart
| Weight | Starting titration dose | Second titration dose | Final titration dose |
|---|---|---|---|
| Pediatric patients less than 40kg | 1.6 mg/kg | 2.3 mg/kg | 3.1 mg/kg |
| Pediatric patients At least 40kg, less than 50kg | 24/26 mg | 49/51 mg | 72/78 mg |
| Pediatric patients At least 50kg | 49/51 mg | 72/78 mg | 97/103 mg |
Entresto dosage restrictions
- Mild hepatic impairment requires no dosage adjustment (Child-Pugh A classification).
- Patients with moderate hepatic impairment (Child-Pugh B classification) should be started at 24mg/26 mg twice daily.
- The use of Entresto is not recommended in patients with severe hepatic impairment (Child-Pugh C classification).
- Patients with mild (eGFR 60 to 90 mL/min/1.73 m^2 ) to moderate (eGFR 30 to 60 mL/min/1.73 m^2 ) renal impairment require no dose adjustment.
- The recommended starting dose in patients with severe renal impairment (eGFR < 30 mL/min/1.73 m^2 ) is 24mg/26 mg twice daily.
How to take Entresto
- Take Entresto exactly as your doctor prescribes it.
- The usual starting dose of Entresto is 49 mg/51 mg taken twice a day. Your doctor may begin you on a lower starting dose or change your dose during treatment.
- If your child cannot swallow tablets, your pharmacist may be able to prepare a liquid suspension using Entresto 49 mg/51 mg tablets. Please note the suspension will also contain Ora-Sweet SF and Ora-Plus. Shake the suspension well before each use.
- 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.
- If you miss a dose of Entresto, take it right away. 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 doctor right away for medical advice or go to the nearest emergency room.
- Discontinue Entresto as soon as possible if you become pregnant as it may cause fetal toxicity.
- It is not recommended to use Entresto while breastfeeding. Discuss with your healthcare provider the benefits and risks of taking Entresto while lactating.
- Read the Instructions for Use and Medication Guide, including the Boxed Warning that comes with your Entresto prescription.
Entresto dosage FAQs
What are some side effects of Entresto?
Some common adverse reactions of Entresto can include:
- Hypotension (low blood pressure)
- Hyperkalemia (high potassium levels)
- Cough
- Dizziness
- Lightheadedness
Some serious side effects of Entresto include:
- Increased risk of angioedema (swelling of your face, lips, tongue, or throat)
- Worsening kidney function, especially in those with congestive heart failure (CHF)
- Severe allergic reactions
You can report any side effects you experience to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
What are some drug interactions with Entresto?
- You should avoid concomitant use with aliskiren if you have an eGFR < 60.
- Potassium-sparing diuretics such as Aldactone (spironolactone) can lead to increased serum potassium.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) can increase your risk of renal impairment.
- Taking lithium with Entresto can increase your risk of lithium toxicity.
Are there any contraindications or precautions with Entresto?
You should not take Entresto if you:
- Have hypersensitivity to Entresto or any of its inactive ingredients.
- Have a history of angioedema related to previous ACEI or ARB therapy.
- Concomitant use with angiotensin-converting enzyme (ACE) inhibitors.
- Concomitant use with aliskiren in patients with diabetes.
- Are pregnant as Entresto may cause fetal toxicity.
How long does Entresto stay in the system?
Based on the half-life of its 2 medications, Entresto will remain in your bloodstream for a little over 2 days after the last dose.
What is the maximum dosage for Entresto?
The maximum dose of Entresto is 97mg/103mg twice daily.
Is it safe to use Entresto while pregnant or breastfeeding?
Entresto use during pregnancy may cause fetal injury or harm. You should discontinue Entresto immediately if you become pregnant. Entresto was found present in rat milk during animal studies so it is not recommended to be used during lactation.
Will lab monitoring be done when taking Eliquis?
While taking Entresto, your doctor may monitor your renal function, blood pressure, and potassium levels.
