Entresto (Sacubitril/Valsartan) 97.2/102.8mg

Angiotensin II Receptor Blocker; Neprilysin Inhibitor

“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.”

CSA NA – FDA Approved – REMS (N) – Can Ship

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.

Heart failure

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.

Oral: Take twice daily

Take with or without food.

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.

1. What do I do if I show signs of high potassium levels (nausea, weakness, irregular heartbeat, tingling sensation, loss of movement)
   Seek immediate medical attention, it may be a rare but potentially serious side effect.
2. This medication is much more expensive than my old ACE-I/ARB, why does my cardiologist insist I take this?
   A large clinical trial showed that patients on this medication with chronic heart failure with reduced ejection fraction had fewer hospitalizations and deaths than being on an ACE-I/ARB alone, which is very important as heart failure patients are high risk for morbidity/mortality.