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Entresto

Generic Name: Sacubitril and valsartan [sak-UE-bi-tril-and-val-SAR-tan]
The Classes of Drugs Are angiotensin receptor blockers and neprilysin inhibitors.

What is Entresto?

Entresto is a mix of sacubitril and Valsartan. Sacubitril is an anti-blood pressure medication. It increases the amount of certain proteins within the body, which dilate (widen) blood vessels. This lowers blood pressure by decreasing sodium levels.Valsartan can be described as an angiotensin II receptor blocker (sometimes known as an ARB). Valsartan prevents blood vessels from swelling, reduces blood pressure, and enhances blood flow.

Entresto is prescribed to patients suffering from chronic heart failure. This medicine can reduce the likelihood of having to be admitted to the hospital in the event of a worsening of symptoms and lower the chance of dying from heart failure.Entresto can also be employed to address heart failure in children who are at least one year old.Entresto is typically prescribed along with other heart medications.

Warnings

Do not use Entresto if you are pregnant. Stop using it and notify your doctor immediately if you fall pregnant. Entresto can cause injury or even death to an unborn baby if you use the medication in the second or third trimester.

If you are diabetic, don't take Entresto in conjunction with any other medication that includes Aliskiren (Tekturna, Tekamlo).

Before you Take this Drug

It is not recommended to take Entresto in the event that you are allergic to sacubitril or Valsartan (Diovan) or if you've experienced an extremely allergic reaction to blood pressure medication, such as:

  • An ACE inhibitor (benazepril, captopril, enalapril, fosinopril, lisinopril, moexipril, perindopril, quinapril, ramipril, trandolapril (Lotensin, Vasotec, Prinivil, Accupril, Mavik, and others)
  • An ARB: azilsartan, candesartan, eprosartan, irbesartan, losartan, olmesartan, telmisartan, and valsartan (Atacand, Avapro, Benicar, Diovan, Edarbi, Micardis, Teveten, and others).

It is not recommended to use Entresto for a period of 36 hours prior to or after taking any ACE-inhibiting medication.If you suffer from diabetes, don't use Entresto in conjunction with any other medicine that contains aliskiren, like Tekturna and Tekamlo.

You might also have to stay clear of taking Entresto with the aliskiren in the event that you suffer from kidney problems.

To ensure that Entresto is suitable for you, ask your doctor if you have ever experienced:

  • Liver disease;
  • Diabetes;
  • Angioedema hereditary;
  • If you are following diets that are low in salt,
  • If you are dehydrated.

Do not use Entresto if you are pregnant. Stop taking it and notify your doctor immediately if you fall pregnant. Entresto can cause injury or even death to a baby that is not born if you use the medication during the third or second trimester of your pregnancy. Use effective birth control.

It is unclear if sacubitril and valsartan are absorbed into breast milk or whether they can harm the nursing infant. It is not recommended to breastfeed when using Entresto.

How to Take Entresto?

Use Entresto exactly as directed by your physician. Follow the directions on the prescription label. Your doctor might alter your dosage to ensure you receive the most effective outcomes. Be sure to not take this medicine in smaller or larger doses or for longer periods than prescribed.You can consume Entresto either with or without meals. The medicine should be taken daily at the same time throughout the day.

Doses of sacubitril and valsartan are based on weight gain in children. The dosage requirements for your child may be altered if the child grows or sheds pounds.

If you're unable to swallow a tablet completely, a pharmacist can create an oral suspension (liquid). Consult your physician if the patient taking this medicine is having trouble eating the tablet.Make sure to shake off the oral suspension (liquid) prior to taking the dosage. Make use of the dosing syringe supplied or a dosage-metering device (not an ordinary spoon).Your blood pressure is likely to be checked regularly. The kidneys may also require a check.

Keep Entresto within the bottle at room temperature, away from heat and moisture. Get rid of the oral suspension that is not used within 15 days from the time of mixing. Do not store the oral suspension in the refrigerator.

Take note of all patient information, such as medication guides and instructions provided to you. Consult your physician or pharmacist for assistance if you have concerns.

Details on Dosage

Usual Adult Dose for Congestive Heart Failure:

Initial dosage: Sacubitril 49 mg and Valsartan 51 mg, taken orally twice a day.
Maintenance dose: Sacubitril, 97 mg Valsartan, 103 mg orally once each day.
Comments:
Increase the dosage for maintenance (sacubitril 97 mg and valsartan 103 mg once every day) within 2 to 4 weeks, based on how well it is tolerated.
A starting dose of sacubitril 24 mg and valsartan 26 mg twice a day is recommended for patients not currently taking an angiotensin-converting enzyme (ACE) inhibitor or an angiotensin receptor blocker (ARB) and also for patients who are already taking lower doses of these drugs. The dose should be increased over a period of 2 to 4 months up to the maintenance dose that is targeted (sacubitril 97 mg/valsartan 103 mg once daily) as tolerated.

Use: To decrease the chance of death from cardiovascular disease and hospitalisation due to heart failure in patients suffering from ongoing New York Heart Association (NYHA) Class II to IV heart failure as well as diminished ejection fraction. Usually given in combination with other treatments for heart failure or in lieu of the ACE inhibitor or another ARB.

What Happens If I Miss a Dose?

Do the dose you missed as soon as you remember. Avoid your missed dose if you are close to the time of the next dose. Take no additional medications in order to compensate for the dose you missed.

What Happens If I Overdose?

For medical emergencies, seek emergency medical attention or contact the Poison Help line at 1-800-222-1222.

What Should be Avoided?

Be careful not to get up too quickly from a lying or seated posture, as you might be shaky. Make sure to get up slowly and steadily to avoid falling.Avoid using sodium supplements, salt replacements, or potassium when you take Entresto unless your physician has instructed you to.

Drinking alcohol could increase your blood pressure and cause an increase in the side effects of Entresto.

Side effects of Entresto

See a doctor immediately. If you are experiencing symptoms warning of an allergic reaction, Entresto: hives; difficulties breathing; or swelling of your lips, face, and tongue. You are more likely to experience a reaction to an allergen if you are African-American.

Make sure to contact your doctor at the earliest opportunity if you are suffering from:

  • A feeling of lightheadedness, as if you've passed out;
  • Extreme tiredness;
  • High potassium levels, a slow heart rate, a weak pulse, and muscle weakness. It may also cause a sensation of tingling,
  • Kidney problems: minimal or no urination; painful or difficult urination. You may also experience swelling in your ankles and feet and feel tired or short of breath.

Common Entresto side effects can include:

  • Kidney problems;
  • High potassium
  • Dizziness, feeling light-headed,
  • Cough.

This isn't a complete list of all the side effects. Other side effects could occur. Contact your doctor to seek medical advice on the effects. You can report symptoms to the FDA at 1-800-FDA-1088.

Interaction with Other Drugs

Discuss with your physician all your medications currently in use and all you are about to start or stop using, in particular:

  • Aliskiren;
  • Lithium;
  • Any other blood pressure medication;
  • A diuretic "water pill";
  • Mineral supplements or medicines that contain potassium
  • These are NSAIDs (nonsteroidal anti-inflammatory medicines): aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac (also known as indomethacin), diclofe, and many others.

This is not a complete list. Other medications can cause interactions with sacubitril and valsartan, such as medications that are prescribed and available over the counter, such as vitamins and herbal products. The interactions of all potential types are mentioned in this medication guide.

DRUG STATUS

Availability

Prescription only

Pregnancy & Lactation

CSA Schedule*
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