Cardiology - Entresto (Sacubitril Valsartan)

You have been given a medicine called Entresto or Sacubitril Valsartan.

Why has my doctor or heart failure nurse given me Entresto (Sacubitril Valsartan)?

Entresto (Sacubitril Valsartan) is a medicine which has been shown to reduce the symptoms of heart failure which means that your heart is not working as well as it should. You are probably already taking medicines to treat this condition but are still experiencing symptoms such as breathlessness, tiredness and ankle swelling. Your Cardiologist or Heart Failure Specialist Nurse considers you may benefit from taking this medicine.

How does it work?

Natriuretic peptides produced by the body cause water and sodium to pass into the urine. This reduces the stress on the heart and lowers blood pressure.

An enzyme called Neprilysin breaks down these peptides. Entresto blocks the effects of the Neprilysin. This allows the natriuretic peptides to reduce stress on the heart, thereby reducing fluid retention and improving your breathlessness symptoms.

How should I take my Entresto (Sacubitril Valsartan)?

Always follow the instructions on the label. Do not stop taking this medicine unless your doctor tells you to stop. Your first prescription for Entresto will be written by the Heart Failure Specialist Nurse or Consultant Cardiologist.

Entresto is prescribed twice daily. One tablet in the morning and one tablet in the evening.

Entresto is available in the following doses:

• 24/26mg twice daily
• 49/51mg twice daily
• 97/103mg twice daily

You will have a blood test organised within 2 weeks of starting your new medication.

You will then have a follow up appointment with your Heart Failure Specialist Nurse to check your blood pressure. If the Entresto is helping it is likely the Heart Failure Specialist Nurse will increase the dose strength.

You should still be taking the tablet twice daily.

The Heart Failure Specialist Nurse will write to your GP to inform them of the changes to your medicines.

If you are taking medicines called ACE inhibitors (e.g. Lisinopril, Ramipril, Perindopril, Quinapril, Enalapril, Trandolapril, Fosinopril) or ARBs (e.g. Valsartan, Candesartan, losartan, Irbesartan, Olmesartan, Eprosartan, Telmisartan) you must stop these 48 hours before taking Entresto.

What should I do if I miss a dose?

Take it as soon as you remember. If it is nearly time for the next dose, do not take the one you missed. Take the next dose at the usual time. Do not double up the next dose.

What are the side effects of Entresto?

Like all medicines, Entresto can cause side effects in some people. The most common side effect is a fall in blood pressure, which may make you feel lightheaded, dizzy or faint. This side effect is likely to become less noticeable with time, but if you cannot cope please contact the Heart Failure Specialist Nurse.

Other side effects may include changes in Kidney and Liver function (How well they are working, as well as fluctuations in the levels of elements in the blood such as Potassium). For this reason, you must have a blood test 2 weeks after starting your new tablets. This will be arranged by your Heart Failure Specialist Nurse.

Stop taking Entresto and seek immediate medical attention if you notice any swelling of the face, lips or tongue and/or throat, which may cause difficulties in breathing or swallowing. These may be signs of angioedema (an uncommon side effect which may affect 1 in 100 people).

For more information about cautions, warnings and side effects please read the patient information leaflet supplied with your medicine.

Can I take other medicines while taking Entresto?

Yes, but some other medicines may affect how Entresto works. It is important that you check with your doctor, heart failure nurse or pharmacist before taking any other medicines, including ones that you buy. The information in this leaflet should be read together with the information provided by the manufacturer of your medication. Please read the leaflets carefully regarding instructions on storing your medication and always keep it out of the reach of children. If you have any concerns regarding your medication contact your pharmacist, doctor or heart failure nurse.