Entresto® (sacubitril/valsartan) tablets for heart failure with reduced EF

What Entresto Is and How It Works

Entresto® contains sacubitril and valsartan. It is a fixed-dose combination used to treat chronic heart failure with reduced ejection fraction in adults and certain pediatric patients as directed by a prescriber. Many people compare Entresto price options and look for ways to save, including patients considering Entresto without insurance. Entresto® is taken by mouth as film-coated tablets, usually twice daily.

Entresto® is an angiotensin receptor neprilysin inhibitor (ARNI). Sacubitril blocks neprilysin, which increases levels of natriuretic peptides that help relax blood vessels, promote sodium excretion, and reduce fluid. Valsartan blocks angiotensin II receptors to lower blood pressure and reduce strain on the heart. Together, these actions help reduce the risk of cardiovascular death and heart failure hospitalization.

YouDrugstore is a licensed Canadian pharmacy in Manitoba that meets Canadian pharmacy standards. Our pharmacists review each prescription before dispensing. We offer brand and generic medicines at Canadian prices, and also carry OTC health products. Ordering is available online, and our friendly customer-service chat is available during posted office hours.

We source through licensed, vetted international partner pharmacies when appropriate, giving you authentic brand medicines, broad selection, and fair pricing.

Dosage and Usage

Entresto® dosing is individualized. Tablets are taken twice daily with or without food. Swallow tablets with water. Do not crush unless your prescriber has advised a specific alternative.

• Starting dose for many adults: 49/51 mg twice daily.
• If not previously on an ACE inhibitor or ARB, or on low doses, start 24/26 mg twice daily.
• Target dose: 97/103 mg twice daily, as tolerated.
• Renal or hepatic impairment may require a lower starting dose.

A 36-hour washout period is required when switching from an ACE inhibitor to Entresto® to lower the risk of angioedema. Discontinue any ARB before starting Entresto®; do not take both together. Do not take Entresto® with aliskiren if you have diabetes. Follow your prescriber’s titration plan and lab monitoring schedule, including potassium and kidney function.

• Missed dose: If a dose is missed, take the next dose at the usual time. Do not double doses.
• Storage: Store at 20–25°C (68–77°F) in a dry place. Keep in the original packaging to protect from moisture.
• Travel: Carry your tablets in your hand luggage. Keep dry, away from heat. Bring extra doses and your prescription label.

Benefits and Savings

Entresto® has been shown to reduce cardiovascular death and heart failure hospitalizations compared with ACE inhibitor therapy in patients with reduced ejection fraction. Many patients report improved exercise tolerance and fewer fluid-related symptoms over time. Twice-daily tablets support steady control and can fit into morning and evening routines.

Buying through a licensed Canadian pharmacy can mean 60–80% savings compared with typical US prices. You can order at a competitive cost even without insurance. Multi-month supplies may lower the per-month cost further, depending on available pack sizes.

Side Effects and Safety

Most side effects are mild to moderate. Not everyone experiences side effects, but patients should know what to watch for and seek timely care when needed.

• Common: dizziness, cough, headache, low blood pressure (especially when standing), fatigue, diarrhea.
• Lab-related: increased potassium (hyperkalemia), increased creatinine or changes in kidney function.
• Serious: angioedema (swelling of face, lips, tongue, or throat), severe hypotension, kidney injury, very high potassium, allergic reactions.

Entresto® is contraindicated in pregnancy and in patients with a history of angioedema related to ACE inhibitors or ARBs. Avoid use with ACE inhibitors (36-hour washout required) and with aliskiren in diabetes. Use caution with potassium-sparing diuretics, potassium supplements, or salt substitutes containing potassium. Alcohol can increase dizziness. Patients with severe liver disease or significant kidney impairment need careful assessment and monitoring.

Report signs of angioedema or severe allergic reaction urgently. Seek medical advice if you have fainting, very slow or irregular heartbeat, reduced urine output, or persistent vomiting and diarrhea.

Onset Time

Blood pressure effects may appear within hours of the first dose. Symptom improvements in heart failure can emerge within one to two weeks in some patients, with greater benefits over several months. Reductions in hospitalization risk and mortality are based on longer-term use in clinical trials.

Compare With Alternatives

Entresto® is often compared with ACE inhibitors such as enalapril. Trials show Entresto® reduced cardiovascular death and hospitalization more than enalapril in appropriate patients with reduced ejection fraction. Compared with ARBs alone, the addition of neprilysin inhibition offers further neurohormonal balance.

SGLT2 inhibitors are now core therapy in heart failure with reduced ejection fraction, regardless of diabetes status. Options include Forxiga® (dapagliflozin) and Jardiance® (empagliflozin). These agents reduce hospitalization risk and support symptom control, and are typically used alongside Entresto® when appropriate.

Other standard therapies include evidence-based beta-blockers and mineralocorticoid receptor antagonists (e.g., spironolactone). Loop diuretics help control congestion but do not reduce mortality. Therapy choices depend on ejection fraction, symptoms, blood pressure, kidney function, and tolerability.

Combination Therapy

Entresto® is commonly combined with a beta-blocker and a mineralocorticoid receptor antagonist when tolerated. Many patients also receive an SGLT2 inhibitor. Diuretics are added for fluid management. Do not combine Entresto® with another ARB or any ACE inhibitor. Use of aliskiren with Entresto® is not recommended in diabetes and may increase risks in others. Potassium and kidney function should be monitored routinely when combining therapies that affect the renin-angiotensin system.

Patient Suitability and Cost-Saving Tips

Patients with chronic heart failure with reduced ejection fraction who can tolerate ARNI therapy may be candidates for Entresto®. It is not for pregnancy. A careful review of prior angioedema history, blood pressure, kidney function, and potassium is essential. People with very low baseline blood pressure may need lower starting doses and gradual titration.

You can lower costs by choosing larger fills where appropriate. Reorder reminders help you avoid gaps in therapy. Our prices often reflect significant savings compared with typical US retail, and multi-month supply options can reduce the monthly spend. For current offers and bulk options, see our Entresto coupon page.

If your heart failure overlaps with other conditions, explore our condition pages on Heart Failure and High Blood Pressure for related products and education. Patients paying out of pocket sometimes ask about Entresto no insurance strategies; comparing pack sizes and considering multi-month fills can help.

Authoritative Sources

Novartis Entresto product page

Health Canada Drug Product Database: Entresto

FDA Prescribing Information for Entresto

YouDrugstore offers caring support from a licensed Canadian pharmacy team. Our pharmacists review prescriptions before dispensing, and our customer-service chat is available during posted office hours. Order securely online and choose prompt, express, cold-chain shipping as needed for your items.

This information is for general knowledge and does not replace advice from your own healthcare professional. Always follow your prescriber’s directions and the patient information supplied with your medication.