ENTRESTO (Sacubitril/Valsartan)

What is this medication? 

Sacubitril+Valsartan, Entresto
Angiotensin II Receptor Blocker; Neprilysin Inhibitor

Entresto is indicated for use in heart failure.

“Alert: Black Box Warning

Fetal toxicity:
Drugs that act directly on the renin-angiotensin system can cause injury and death to the developing fetus. When pregnancy is detected, discontinue valsartan as soon as possible.”

How does this medication work? 

Sacubitril+Valsartan, Entresto works through two distinct mechanisms of action.  Valsartan blocks the action of angiotensin II which acts as a vasoconstrictor and activator of aldosterone release.  Hence, the displacement of angiotensin II by Valsartan is responsible for its blood pressure lowering effect.  Sacubitril is a prodrug that inhibits neprilysin (neutral endopeptidase) through the active metabolite LBQ657, leading to increased levels of peptides, including natriuretic peptides; induces vasodilation and natriuresis.

How should I take this medication? 

Oral: Take twice daily

Take with or without food.

What should I watch for while using this medication? 

Before starting Sacubitril+Valsartan, Entresto make sure your physician is aware of any allergies or medications you currently take.  As with any other angiotensin II receptor antagonist, there is are risks of hyperkalemia, hypotension, deterioration in renal function.  Valsartan should be used with caution in patients who have ascites, heart failure, hepatic and renal impairment, and renal artery stenosis.

What if I miss a dose?

If you miss a dose of medication, try to take it as soon as possible.  However, if it is almost time for your next dose, take only that scheduled dose.  Do not take double or extra doses.

How should I store this medication?

Keep out of the reach of children at all times.  Store at room temperature, 59 to 86° F (15 to 30° C).  Protect from light.  Keep the container tightly closed.  Properly dispose of any unused medication after the expiration date.

What are the possible side effects of using this medication? 

Dizziness, hypotension, orthostatic hypotension, fatigue, headache, hyperkalemia, diarrhea, abdominal pain, nausea, joint pain, dry cough.

Note this is not a complete list of side effects for Sacubitril+Valsartan, Entresto only common ones.