Key takeaways:
Entresto (sacubitril / valsartan) is a medication that treats heart failure. Most of the time, it’s prescribed as a long-term medication.
If you suddenly stop taking Entresto, your heart failure symptoms may get worse. If you’re having problems getting or taking the medication, talk to someone on your healthcare team.
Entresto is standard treatment for heart failure. But like all medications, it can cause side effects, and some people will need to stop taking it.
Entresto should never be combined with angiotensin-converting enzyme (ACE) inhibitors, like lisinopril, enalapril, and ramipril. Taking these medications together can increase your risk of life-threatening complications.
Save on related medications
Entresto (sacubitril / valsartan) is a medication that treats heart failure in adults and children. It improves symptoms and reduces the risk of hospitalization and death related to heart failure. Because Entresto has such important benefits, stopping it can cause problems for some people.
If your healthcare team recommends Entresto, learning about the medicine can help you take an active role in your care. This includes understanding how Entresto works and how to take it safely. It also helps to know which side effects to watch for, what can happen if you stop taking it, and when to contact your healthcare team.
1. Stopping Entresto suddenly isn’t usually a good idea
Stopping Entresto may make heart failure worse.
One study found that people who stopped taking Entresto had worse heart function and more heart failure symptoms than those who continued taking it, even if they switched to another medication.
Usually it’s not a good idea to stop Entresto without consulting your healthcare team first. But there are some important reasons that you may need to stop Entresto quickly:
Side effects: If you have side effects from Entresto, like kidney issues or high potassium levels, a healthcare professional may recommend switching to another heart failure medication. We’ll tell you more about possible side effects later in this article.
Angioedema: If you develop angioedema, you should stop Entresto. This is a rare but serious side effect. It shows up as swelling in your face, tongue, throat, or neck. In severe cases, it can lead to difficulty breathing, which can be life-threatening. If this happens, go to the emergency room right away.
Pregnancy: If you’re pregnant or planning to get pregnant, you should stop taking Entresto. That’s because it can harm a developing fetus. Your medical team can help you find a safer alternative.
It’s also important to know that angiotensin-converting enzyme (ACE) inhibitors, like enalapril, ramipril, and lisinopril, should never be combined with Entresto. That’s because this combination raises the risk for angioedema. This is one reason why it’s important that the members of your healthcare team have a list of all your medications.
Possible side effects of stopping Entresto treatment
Potential side effects of stopping Entresto include symptoms of worsening heart failure. These may include:
Shortness of breath
Swelling in your legs
Coughing
Difficulty lying flat
Rapid heart rate
Fatigue
Dizziness
If your healthcare team recommends stopping Entresto, you usually won’t need to taper your dose. Most of the time, you can just stop taking it. Depending on your situation, another heart failure medication may be prescribed to replace Entresto.
2. You may need to take Entresto for the long term
Most people need to take Entresto for a long time to get the full benefits of the medication. That is, as long as it’s not causing side effects.
Studies show that stopping heart failure treatment too early leads to worse outcomes. This includes a higher risk of hospitalization and death related to heart failure.
Heart failure medications like Entresto can improve your ejection fraction (EF). This measurement tells you about the strength of the heart and how much blood it pumps with each beat. A lower EF means your heart function is weaker than normal. If you stop taking Entresto, your EF may get lower.
3. Entresto may take months to improve heart function
It takes about 2 hours for Entresto to start working after you take a dose. You may not feel any different at first, although your blood pressure may be a little lower. But the full benefits of Entresto take longer to show up.
Several studies have looked at how long Entresto takes to work:
The PROVE-HF study looked at people with heart failure who were treated with Entresto. Researchers found that some signs of heart stress improved within 2 weeks.
The same study also showed that Entresto improved EF. People in the study had better EF within 6 months, with even more improvements by 12 months.
In the PARADIGM-HF study, Entresto was compared with another heart failure medicine called enalapril (Vasotec). People who took Entresto had better outcomes as early as 30 days after starting treatment. This included a lower risk of being hospitalized for heart failure.
4. Entresto is most effective when taken twice a day
Entresto can stay in your system for over 2 days. But that doesn’t mean it’s working at its peak that entire time. After several hours, Entresto doesn’t have as much of an effect on your body. This is why it’s usually taken twice a day.
It may seem more convenient to only take Entresto once a day, but this may prevent you from getting the full benefits.
5. Entresto is considered safe, but it’s a good idea to be aware of potential side effects
Entresto is generally considered safe and effective for treating heart failure. But like all medications, it has potential side effects and interactions with other medications to be aware of.
Entresto side effects may include:
Low blood pressure (hypotension)
High potassium levels
Cough
Dizziness
Kidney problems
Entresto can also interact with certain medications, including:
Aliskiren (Tekturna): In people with diabetes or kidney disease, taking aliskiren with Entresto increases your risk of kidney damage.
Angiotensin-converting enzyme (ACE) inhibitors: Combining Entresto with ACE inhibitors, like lisinopril (Prinivil), increases the risk of angioedema.
Angiotensin II receptor blockers (ARBs): Entresto already contains an ARB (valsartan). Taking more than one ARB, such as losartan (Cozaar), increases the risk of side effects.
If you’ve had angioedema from an ACE inhibitor or ARB in the past, or if you have hereditary angioedema, you usually shouldn’t take Entresto.
How to save on Entresto
Entresto is available as a generic medication. But there are a few ways to save on brand-name Entresto:
Receive a free month of Entresto. Entresto’s manufacturer offers a one-time, free 30-day supply of Entresto. Anyone can sign up for this free trial, regardless of insurance status.
Use a manufacturer’s savings card. If you have commercial insurance, you may be eligible to receive Entresto for as little as $10 per prescription with a copay savings card from the manufacturer.
Enroll in a patient assistance program. If you’re uninsured or underinsured, you may qualify for Entresto’s patient assistance program. If you’re eligible, you could receive Entresto free of cost.
Frequently asked questions
Taking Entresto with meloxicam can increase your risk of kidney damage and raise potassium levels in your blood, which can be dangerous.
Meloxicam belongs to a group of medications called nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen, naproxen, and celecoxib. NSAIDs can worsen heart failure by raising blood pressure and causing your body to hold onto fluids. For these reasons, most people shouldn’t take Entresto with meloxicam or other NSAIDs.
When Entresto was first approved, some researchers were concerned that it might affect a part of your eye called the retina. But so far there’s no evidence that Entresto directly harms your eyes. Some people may notice blurry vision while taking it. This can happen if Entresto lowers your blood pressure too much. Low blood pressure can also cause dizziness, lightheadedness, or fainting.
Studies have looked at whether Entresto affects memory or thinking, and so far, it doesn’t seem to cause forgetfulness or dementia. But Entresto can cause low blood pressure, which may lead to confusion and dizziness. If you notice forgetfulness or confusion after starting Entresto or changing your dose, check in with your healthcare team. They may want to check your blood pressure, kidney function, and electrolytes.
Taking Entresto with meloxicam can increase your risk of kidney damage and raise potassium levels in your blood, which can be dangerous.
Meloxicam belongs to a group of medications called nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen, naproxen, and celecoxib. NSAIDs can worsen heart failure by raising blood pressure and causing your body to hold onto fluids. For these reasons, most people shouldn’t take Entresto with meloxicam or other NSAIDs.
When Entresto was first approved, some researchers were concerned that it might affect a part of your eye called the retina. But so far there’s no evidence that Entresto directly harms your eyes. Some people may notice blurry vision while taking it. This can happen if Entresto lowers your blood pressure too much. Low blood pressure can also cause dizziness, lightheadedness, or fainting.
Studies have looked at whether Entresto affects memory or thinking, and so far, it doesn’t seem to cause forgetfulness or dementia. But Entresto can cause low blood pressure, which may lead to confusion and dizziness. If you notice forgetfulness or confusion after starting Entresto or changing your dose, check in with your healthcare team. They may want to check your blood pressure, kidney function, and electrolytes.
The bottom line
Entresto (sacubitril / valsartan) is a medication that’s taken by mouth. It’s FDA-approved to treat heart failure in both adults and children. In most cases, Entresto is taken long term. It can help your heart work better and may help you to feel better.
But if you stop taking heart failure medications like Entresto, those benefits may go away. Unless you’re having a life-threatening side effect like angioedema, don’t stop taking Entresto without talking to your healthcare team first. They can help you decide whether you should stop treatment, change your dose, or switch to another heart failure medication that’ll work better for you.
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References
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