Entresto

The active ingredients in Entresto are sacubitril and valsartan. Sacubitril is a neprilysin inhibitor that works by blocking the activity of an enzyme called neprilysin. It is responsible for breaking down substances called natriuretic peptides, which help relax blood vessels and reduce blood pressure.

Valsartan, is an angiotensin II receptor blocker (ARB). It works by blocking the action of a hormone called angiotensin II, which causes blood vessels to constrict or tighten. By doing this, it helps to widen blood vessels, lower blood pressure, and improve blood flow to the heart and other organs. This relieves the workload on the heart and helps your kidneys remove excess fluid and salt from your body.

Follow all directions given to you by your doctor and read all documents provided, including the full Prescribing Information, FDA-Approved Product Labeling, Instructions for Use, and Medication Guide before using Entresto. However, the following is a synopsis of the general guidelines for the use of Entresto:

For adults, the typical initial dose of Entresto (sacubitril/valsartan) is 49 mg/51 mg taken orally twice a day. However, your healthcare provider may adjust the dose based on your response to the medication. In the case of children, the dosing of Entresto will depend on their weight and will be determined by their healthcare provider.

For patients who are not currently taking an ACE inhibitor or an angiotensin II receptor blocker (ARB), or for those who were previously taking low doses of these medications, it is recommended to start Entresto at half the usual starting dose. After starting treatment, the dose can be increased gradually every 2 to 4 weeks in adults and every 2 weeks in pediatric patients until the recommended dose is reached.

If you forget to take a dose of Entresto, take it as soon as you remember. However, if it's almost time for your next scheduled dose, it's best to skip the missed dose and continue with your regular dosing schedule. Taking two doses close together can increase the risk of side effects.

The most common side effects of Entresto include:

• Low blood pressure
• High potassium levels
• Cough
• Dizziness
• Kidney problems
• Lightheaded

Some individuals may experience serious side effects while using Entresto. These side effects may require immediate medical attention. If you experience any of the following, contact your healthcare provider or seek emergency medical help:

• Serious allergic reaction (angioedema)
• This can cause your face to swell, as well as your lips, tongue, and throat, which may cause trouble breathing if you experience this do not take Entresto.
• Receive medical attention immediately if you experience any of the symptoms of an allergic reaction.
• Kidney damage
• Your provider may run labs to make sure your kidneys are working properly. If you are urinating less often than usual, let them know right away.

These are not all of the possible side effects of Entresto. You should always seek medical advice from your healthcare provider for any questions or concerns about your medical condition or treatment. Read all patient information, medication guides, or drug information sheets that come with this medication. You can also report adverse effects to the Food and Drug Administration at www.fda.gov/medwatch or 1-800-FDA-1088.

Before starting Entresto, it is crucial to discuss any existing health conditions with your healthcare provider. This medicine may not be safe for you or you may need to start at a lower dose. You should be sure that your healthcare provider is aware of all your medical conditions, including if you have:

• A history of hereditary angioedema (a disorder that causes severe swelling)
• Liver disease
• Poor kidney function
• Hypotension (low blood pressure), or depleted volume and salt levels
• A plan to become pregnant, are currently pregnant, or are breastfeeding
• Hyperkalemia, (high potassium levels in the blood)
• Diabetes and are currently taking a medication that contains Aliskiren

Boxed Warning

Please note that the information provided is not intended to replace or substitute the full prescribing information for Entresto (sacubitril/valsartan). It is crucial to consult the complete boxed warning and prescribing information for comprehensive details regarding the use, precautions, and contraindications of Entresto.

It is important to discontinue Entresto (sacubitril/valsartan) as soon as pregnancy is detected. Drugs that directly affect the renin-angiotensin system, like Entresto, can cause harm or even be fatal to the developing fetus. Therefore, it is necessary to take appropriate measures and consult with your healthcare provider if you are pregnant or planning to become pregnant while using Entresto. They will provide you with the necessary guidance and make any necessary adjustments to your treatment plan.

• History of angioedema related to previous ACEi or ARB therapy.
• Hypersensitivity to any component.
• Concomitant use with ACE inhibitors.
• Concomitant use with aliskiren in patients with renal impairment.

Entresto begins to lower blood pressure within hours of the first dose, but its full benefits in managing heart failure may take weeks to develop. Improvement in symptoms like shortness of breath or reduced fatigue might be noticed within a few weeks. However, it’s important to continue taking Entresto as prescribed, as long-term use provides the greatest benefit in reducing the risk of cardiovascular death and hospitalizations.

When Entresto is taken with other prescription drugs, over-the-counter medications, vitamins, and supplements, it may change how they work or increase the frequency or severity of side effects. Make sure that you tell your healthcare professional about anything that you are taking to mitigate harmful drug interactions, including:

• Angiotensin-converting enzyme (ACE) inhibitors.
• Potassium-sparing diuretics, such as spironolactone, triamterene, and amiloride, as well as potassium supplements or salt substitutes containing potassium.
• Nonsteroidal anti-inflammatory drugs (NSAIDs) or selective cyclooxygenase-2 inhibitors (COX-2 inhibitors) such as ibuprofen, naproxen, or celecoxib.
• Lithium

Entresto (sacubitril/valsartan) is available in film-coated tablets and comes in several dosage strengths such as:

• Entresto 24 mg/26 mg: Each tablet contains 24 mg of sacubitril and 26 mg of valsartan.
• Entresto 49 mg/51 mg: Each tablet contains 49 mg of sacubitril and 51 mg of valsartan.
• Entresto 97 mg/103 mg: Each tablet contains 97 mg of sacubitril and 103 mg of valsartan.

Keep Entresto tablets at room temperature between 68°F to 77°F (20°C to 25°C) in a dry place to protect them from moisture. It is important not to refrigerate the Entresto oral suspension but to store it at room temperature below 77°F (25°C) for a maximum of 15 days. Remember to keep the medication out of reach of children and consult your healthcare provider if you have any specific concerns or questions.

It is manufactured by Novartis, Inc.

Currently, there is no generic available for Entresto in the United States. Some related medications include Vasotec (enalapril) and Spironolactone (spironolactone).

To stop taking Entresto, consult your healthcare provider first, as abruptly discontinuing the medication may worsen heart failure symptoms. Your doctor may adjust your treatment plan or transition you to another medication to manage your condition.

Entresto should not be used during pregnancy due to the risk of harm to the developing fetus. Talk to your doctor if you are already pregnant or if you have any plans to become pregnant. They can suggest a safer option to use while you are pregnant.

Entresto is not recommended while breastfeeding because of the risk of serious side effects in breastfed infants. Talk to your doctor if you are already breastfeeding or if you have any plans to breastfeed. They can give you other treatment options and ways to feed your child.