Entresto Dosages: Your GoodRx Guide
Key takeaways:
Entresto (sacubitril/valsartan) is FDA approved to treat heart failure in adults and children ages 1 year or older. It’s taken by mouth twice daily.
Entresto is available in three different strengths as an oral tablet, but it can also be prepared into an oral liquid at a pharmacy. It’s important to talk to your healthcare provider about your appropriate starting dose and any necessary dosage adjustments.
There are ways to save on Entresto. If you’re eligible, a manufacturer savings card can help you access Entresto for as little as $10 per month. A patient assistance program is also available.
Table of contents
Entresto (sacubitril/valsartan) is a first-choice medication for treating heart failure. What’s more, it’s FDA approved to treat two different forms of heart failure: heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF). It can help people with heart failure live longer and avoid hospitalizations.
Entresto — which is the only available angiotensin receptor neprilysin inhibitor medication — is actually a type of combination treatment. It contains sacubitril, which is a neprilysin inhibitor, and valsartan, which is an angiotensin II receptor blocker (ARB). Entresto’s dosages are based on how much medication one tablet contains, with sacubitril listed first and valsartan listed second.
This Entresto dosing guide provides general recommendations about approved Entresto dosages. But you should always speak with your healthcare provider about the dose that’s right for you.
What’s the typical Entresto dosage for adults?
Entresto is an oral tablet that comes in three doses: 24 mg/26 mg, 49 mg/51 mg, and 97 mg/103 mg of sacubitril/valsartan. It’s recommended to take it twice daily.
The typical starting Entresto dosage for adults is 49 mg/51 mg twice daily. Your healthcare provider will track your response to this dose and if tolerated, adjust it to the higher 97 mg/103 mg twice daily dose. This higher dose is the target maintenance dose. This adjustment usually happens 2 to 4 weeks after starting the medication, based on how well it’s tolerated and how well it’s working.
What’s the typical Entresto dosage for children?
Entresto is also FDA approved to treat heart failure in kids who are at least 1 year old. It’s still taken twice daily, but the right dose will depend on your child’s body weight.
In most cases, your child’s dose will slowly go up as their body gets used to the medication. The starting dose is typically taken for 2 weeks. If tolerated, it can be adjusted to the “second step” dosage listed below. After another 2 weeks at this middle dose, it can be adjusted again to the target maintenance dose.
Body weight | Starting dose* | Second step dose* | Target maintenance dose* |
Less than 40 kg (88 lb) | 1.6 mg of combined sacubitril and valsartan per kg | 2.3 mg of combined sacubitril and valsartan per kg | 3.1 mg of combined sacubitril and valsartan per kg |
Between 40 kg and 50 kg (110 lb) | 24/26 mg | 49/51 mg | 72/78 mg |
More than 50 kg | 49/51 mg | 72/78 mg | 97/103 mg |
*Doses are to be taken twice daily
For children who can’t swallow tablets, or who weigh less than 40 kg, it’s recommended to use an oral liquid instead of tablets. The oral liquid must be prepared by a pharmacy that compounds medications. It’s not recommended to do this on your own at home. Based on your child’s body weight and the dose needed, the pharmacy will convert Entresto tablets into a liquid. Once the liquid is prepared, it can be stored at room temperature for up to 15 days.
For children who weigh 40 kg or more, keep in mind that the 72/78 mg dosage is not available in one individual tablet. If this is the dose they need, it’s recommended to take 3 tablets of the 24/26 mg pill for each dose. This will equal 72/78 mg.
Are there any dosage adjustments for medical conditions?
Possibly. Your dose might be different if you have certain medical conditions. If you have kidney or liver problems, your healthcare provider may consider a lower Entresto dose.
Your healthcare provider may also reduce the starting dose if you’re not currently taking an ARB, like losartan (Cozaar), or an angiotensin-converting enzyme (ACE) inhibitor, like lisinopril (Zestril), before switching to Entresto. This is also the case if you were previously taking a low dose of an ARB or ACE inhibitor. Taking either of these medications builds tolerance to Entresto, which makes it more likely that you can tolerate Entresto at the typical starting dose.
Keep in mind: You should not take an ARB or ACE inhibitor and Entresto together. It’s important to safely switch over with the help of your healthcare provider.
What happens if you miss a dose of Entresto?
It’s important to take Entresto regularly as it’s prescribed. But missed doses can sometimes happen. If you miss a dose of Entresto, take it as soon as you remember.
But if it’s almost time for your next dose, don’t take your missed dose. Instead, take the next dose at the usual time. You don’t want to double up on doses too close together. This can lead to too much medication in your body.
What should you do if you take too much Entresto?
If you take too much Entresto, don’t panic. Limited reports of one-time high Entresto dosages didn’t have severe consequences.
However, there is still a risk of possibly dangerous side effects. Possible risks include:
Very low blood pressure
Dizziness or lightheadedness that could lead to a fall
Very high potassium levels
Worsened kidney problems
If you or someone you know took too much Entresto, contact your healthcare provider or call Poison Control at 1-800-222-1222. But if you’re experiencing symptoms that feel worrisome or severe, go to the nearest emergency room right away.
What’s more, taking steps to prevent an Entresto overdose is ideal. It’s helpful to organize your medications — especially if you take multiple — to avoid taking too much.
How to save on Entresto
There are ways to save on Entresto, which is only available as a brand-name medication. GoodRx can help you navigate between patient assistance programs and copay savings cards to save money on your prescription.
Save with patient assistance programs.If you’re uninsured or underinsured, you may be eligible for Entresto’s patient assistance program, which offers the medication free of cost.
Save with a copay savings card. If you have commercial insurance, you may be eligible to pay as little as $10 for Entresto using a savings card from the manufacturer.
The bottom line
Most adults take Entresto at a starting dosage of 1 tablet (49 mg/51 mg) twice daily. Those with kidney problems, liver problems, or those who haven’t taken an ARB or ACE inhibitor before may start with a lower dose. After a few weeks, the dose can be adjusted by your healthcare provider to the target dose based on how well you tolerate it. Children’s Entresto dosages are based on body weight.
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References
Heidenreich, P. A., et al. (2022). 2022 AHA/ACC/HFSA Guideline for the management of heart failure: A report of the American College of Cardiology/American Heart Association joint committee on clinical practice guidelines. Circulation.
Novartis. (2021). Novartis Entresto granted expanded indication in chronic heart failure by FDA.
Novartis. (2022). Entresto [package insert].
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