What is Entresto Uses, warnings & interactions
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Get started todayEntresto (sacubitril/valsartan) is a prescription medication that is indicated 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.
Entresto overview
- Entresto
- Reduce the risk of heart failure
- Sacubitril/valsartan
- Oral
- Film-coated tablet
- ARNI
What is Entresto used for?
Entresto (sacubitril/valsartan) is a prescription angiotensin receptor neprilysin inhibitor (ARNI) that is 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 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 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 most commonly prescribed doses of Entresto?
- 24mg/26 mg tablet
- 49mg/51 mg tablet
- 97mg/103 mg tablet
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.
- 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 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 Instructions for Use and Medication Guide, including the Boxed Warning that comes with your Entresto prescription.
Entresto contraindications
Entresto is contraindicated if you have any of the following:
- 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
Entresto warnings
- Observe for signs and symptoms of angioedema (swelling of your face, lips, tongue, throat) and hypotension (low blood pressure).
- Monitor renal function and potassium levels if indicated.
- Allergic reactions have occurred with Entresto. You should 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.
- Entresto can increase your potassium levels. Before using potassium supplements or salt substitutes that contain potassium, consult your healthcare provider.
Entresto drug interactions
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.
Side effects of Entresto
Some common side effects of Entresto 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)
You can report any side effects you experience to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
Entresto alternatives
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:
- Diovan (valsartan)
- Cozaar (losartan)
- Vasotec (enalapril)
- Prinivil (lisinopril)
Is Entresto better than Vasotec (enalapril)?
While they both can be used to treat heart failure, Entresto and enalapril there is a study that has compared their effectiveness in certain patients. According to the PIONEER-HF study, starting heart failure patients on Entresto in the hospital led to better outcomes than enalapril, which is the standard treatment. After 8 weeks of treatment, Entresto patients had a 46% reduction in the risk of re-hospitalization, needing a left ventricular assist device (LVAD), transplant, and death.
There is a big price between the two medications. Metformin is relatively inexpensive and costs about $15 for a month’s supply of #60, 20mg tablets. Entresto is much more expensive, costing close to $700 for a month’s supply of #60, 24mg/26mg tablets.
Entresto FAQs
What doses of Entresto are available?
Entresto is a film-coated tablet taken by mouth that’s available in strengths of 24mg/26mg, 49mg/51mg, and 97/103mg.
How long does Entresto stay in the system?
Entresto is a combination medicine that will remain in your bloodstream for a little over 2 days after your last dose.
How do I store Entresto?
Entresto should be stored at room temperature 68°F to 77°F (20°C to 25°C) away from light and moisture.
How long does it take for Entresto to start working?
Although steady-state levels of Entresto are reached in 3 days, the clinical effectiveness will vary between patients.
Is there a generic for Entresto?
Currently, there is not a generic for Entresto available on the market. However, you can still save on brand-name drugs like Entresto with the help of NiceRx.
