Entresto (Sacubitril/Valsartan)

Indications

Entresto (Sacubitril/Valsartan) is an oral medication recently approved as a treatment for heart failure and reducing the risk of cardiovascular problems. Entresto is classified as an Angiotensin Receptor Neprilysin Inhibitor (ARNI) and is used in adults to reduce the risk of death and hospitalization in patients with chronic heart failure (NYHA Class II-IV) and reduced ejection fraction.

Entresto is a combination of the neprilysin inhibitor (sacubitril), and the angiotensin II receptor blocker/ARB (valsartan) used to treat symptomatic heart failure in pediatric and adult patients with systemic left ventricular systolic dysfunction. It is a combination of two different drugs, sacubitril and valsartan, and works by inhibiting the activity of angiotensin-converting enzyme (ACE), an enzyme responsible for regulating blood pressure.

Sacubitril/Valsartan are an active ingredient of Entresto that has recently been approved by the U.S. Food and Drug Administration to be used in treating adults with heart failure in 2015. Entresto works by increasing natriuretic peptide levels and inhibiting the effects of angiotensin II, thereby relaxing the blood vessels, and allowing blood to flow more freely, making it easier for the heart to pump blood throughout the body.

Uses and Dosage

Entresto tablet should be taken orally, usually twice daily with or without food, as prescribed by the doctor. The tablet should be swallowed whole, and a glass of water should be consumed immediately afterwards. The film-coated tablets should not be split or divided.

Entresto is a medication used to treat heart failure. To use Entresto, the recommended starting dose is 49/51 mg taken twice daily. If the patient tolerates the medication well, the dose should then be increased to the target maintenance dose of 97/103 mg taken twice daily. It is important to follow your doctor's instructions when taking Entresto.

Side effects

The Most Common side effects Entresto:

• Abdominal or stomach pain
• Difficult breathing
• Dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
• Irregular heartbeat
• Nausea or vomiting
• Numbness or tingling in the hands, feet, or lips
• Weakness or heaviness of the legs

Some Serious Side Effects Including:

• Hypotension or low blood pressure
• Hyperkalemia (high potassium levels in the blood)
• Changes in urine output
• Muscle weakness
• Irregular heartbeat
• Fainting

Form and strength

Entresto and its generic alternative form Sacubitril/Valsartan are available in the following forms and strengths:

Entresto Tablet:

• 24/26mg
• 49/51mg
• 97/103mg

Sacubitril/Valsartan Tablet:

• 24/26mg
• 49/51mg
• 97/103mg

Cautions

• If pregnancy is detected, this medication should be discontinued immediately. During the second and third trimesters of pregnancy, oligohydramnios – a condition where there is too little amniotic fluid in the uterus – may occur, which can lead to fetal injury such as hypotension, neonatal skull hypoplasia, anuria, reversible and irreversible renal failure, and even death.
• If you have any allergies to sacubitril, valsartan, other ARBs (such as candesartan and losartan), ACE inhibitors (such as quinapril and ramipril), or any other allergies, you inform your physician or pharmacist. Additionally, this product may contain inactive ingredients that can cause allergic reactions or other issues.
• If you have any history of liver or kidney disease, dehydration, an elevated level of potassium in the blood, or any serious allergic reactions that included swelling of the face/lips/tongue/throat/difficulty breathing (such as angioedema or hereditary angioedema), you need to talk with doctor or pharmacist about your medical history.
• Entrestot may cause dizziness. The use of alcohol or marijuana (cannabis) can exacerbate this effect, so caution should be taken while driving, operating machinery, or engaging in activities that require alertness. Alcohol consumption should be limited, and if you are using marijuana (cannabis), please consult with your doctor.

Frequently Asked Questions (FAQ)

How long should I take Entresto?

Entresto should be taken for at least 12 weeks. In some cases, the treatment may be extended for up to 2 years. The duration of Entresto treatment depends on the severity of the patient's condition and how they respond to the medication.

How does Entresto interact with other medications?

Entresto may interact with other medications. Some medications may increase the risk of side effects when taken with Entresto, while others may reduce the effectiveness of Entresto. If you are taking any other medications, make sure to discuss them with your doctor before starting Entresto.

Is Entresto used long term?

Entresto is FDA-approved for chronic (long-term) heart failure in adults. It was originally approved for adults and children over 1 year of age with heart failure with reduced ejection fraction (HFrEF).

Resources

• Cada DJ, Baker DE, Leonard J. Sacubitril/Valsartan. Hosp Pharm. 2015 Nov; 50(11): 1025-36. [PMC free article] [PubMed]
• https://reference.medscape.com/drug/entresto-sacubitril-valsartan-1000010#6
• Drugs and Lactation Database (LactMed) [Internet]. National Library of Medicine (US); Bethesda (MD): Feb 28, 2019. Sacubitril. [PubMed]
• https://www.ncbi.nlm.nih.gov/books/NBK507904/
• https://www.webmd.com/drugs/2/drug-169241/entresto-oral/details