Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Entresto.
Angioedema: Angioedema is a condition where the deeper layers of the skin around the eyes and lips swell. It can be life-threatening if the swelling is severe enough to cause the throat or tongue to swell and block the airways. The risk of developing angioedema with Entresto increases if it is taken with other ARBs (angiotensin receptor blockers) or any medications in the family of angiotensin-converting enzyme inhibitors (ACEIs).
This condition has been associated with ARBs such as valsartan and may occur with Entresto. If you have experienced angioedema in the past with ACEIs or ARBs, discuss with your doctor how Entresto may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Entresto, and whether any special monitoring is needed.
Low blood pressure: Sacubitril - valsartan may cause a lowering of blood pressure when rising from a sitting or lying position, or a racing heart rate, especially during the first few weeks of treatment. If you feel dizzy or lightheaded or feel your pulse is racing, and this feeling does not go away after a few minutes, call your doctor. Because Entresto can cause dizziness or lightheadedness, do not get up too quickly after you have been sitting or lying for prolonged periods. If you have heart disease (e.g., heart failure, Heart Attack) or are taking medications that lower blood pressure, discuss with your doctor how Entresto may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Entresto, and whether any special monitoring is needed.
Kidney problems: Valsartan can cause changes to kidney function that may result in decreased kidney function, kidney failure, or possibly death. Certain people have experienced changes in kidney function (e.g., people with narrowed blood vessels in their kidneys, or those with severe Congestive Heart Failure).
The use of aliskiren with Entresto may further increase risk of kidney problems for people already at risk for this problem. If you have reduced kidney function, renal artery stenosis (narrowing of blood vessels in the kidneys), or congestive heart failure, discuss with your doctor how Entresto may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Entresto, and whether any special monitoring is needed. If you have reduced kidney function, you may require lower doses of Entresto.
Entresto should not be taken by people with severely decreased kidney function.
Liver problems: Liver disease or reduced liver function may cause Entresto to build up in the body, causing side effects. People with reduced liver function may need a lower-than-normal dose of valsartan; therefore, it may be necessary to use the components of the combination product separately. If you have reduced liver function or liver disease, discuss with your doctor how Entresto may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Entresto, and whether any special monitoring is needed. Entresto is not recommended for people with severe liver impairment.
Entresto may also cause a decrease in liver function. If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.
Potassium levels: Increases in blood levels of potassium occur for some people who take sacubitril - valsartan. Potassium levels should be monitored by your doctor. If you experience unexplained nausea, fatigue, muscle weakness, or tingling sensations, contact your doctor.
If you have diabetes, severely reduced kidney function, or a high potassium intake in your diet, discuss with your doctor how Entresto may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Entresto, and whether any special monitoring is needed.
Pregnancy: Valsartan may cause severe harm to an unborn fetus and should not be used during pregnancy. If you become pregnant while taking Entresto, stop taking it immediately and call your doctor. It is important to use effective birth control while taking Entresto and for 1 week after the last dose.
Breast-feeding: It is not known if sacubitril - valsartan passes into breast milk. If you are a breast-feeding mother and are taking Entresto, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of using Entresto have not been established for children.
