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Entresto is a prescription combination of sacubitril and valsartan. It reduces cardiovascular death and heart failure hospitalization in adults with chronic heart failure, with benefits most evident when left ventricular ejection fraction is below normal. It also treats symptomatic heart failure with systemic left ventricular systolic dysfunction in patients age 1 and older.
read more about entresto ...Sacubitril is converted to LBQ657, which inhibits neprilysin and raises concentrations of peptides such as natriuretic peptides. Valsartan blocks the angiotensin II type 1 receptor and reduces angiotensin II effects, including aldosterone release. The combination acts on both neprilysin and the renin-angiotensin system.
Entresto is used in adults with chronic heart failure to reduce cardiovascular death and hospitalization risk. It is also indicated from age 1 for symptomatic heart failure with systemic left ventricular systolic dysfunction. Pediatric dosing is weight based, while adult dosing uses fixed tablet strengths.
The recommended adult starting dose is 49 mg sacubitril with 51 mg valsartan twice daily. The target maintenance dose is 97 mg with 103 mg twice daily. Adult doses are adjusted every two to four weeks as tolerated. Lower starting doses are used in selected patients with prior low-dose therapy, severe kidney impairment, or moderate liver impairment.
Entresto carries a boxed warning for fetal toxicity and is stopped when pregnancy is detected. Other serious concerns include angioedema, low blood pressure, impaired kidney function, and high potassium. It is contraindicated with ACE inhibitors, and a 36-hour interval is required when switching between Entresto and an ACE inhibitor.
Entresto treats chronic heart failure in adults and symptomatic systolic heart failure from age 1.
The recommended adult starting dose is 49 mg sacubitril with 51 mg valsartan twice daily.
The target maintenance dose is 97 mg sacubitril with 103 mg valsartan twice daily.
No. Concomitant use is contraindicated, and a 36-hour washout is required when switching.
2024 First Generic Drug Approvals. https://www.fda.gov/drugs/drug-and-biologic-approval-and-ind-activity-reports/2024-first-generic-drug-approvals. Date Accessed September 29, 2026.
ENTRESTO (Sacubitril and Valsartan) Prescribing Information. https://www.dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=000dc81d-ab91-450c-8eae-8eb74e72296f. Date Accessed September 29, 2026.
Entresto (Sacubitril and Valsartan) Product Information. https://www.novartis.com/us-en/content/entresto%E2%84%A2-tablets. Date Accessed September 29, 2026.
Influence of Ejection Fraction on Outcomes and Efficacy of Sacubitril/Valsartan in Heart Failure With Reduced Ejection Fraction: The PARADIGM-HF Trial. https://pubmed.ncbi.nlm.nih.gov/26915374/. Date Accessed September 29, 2026.
Valsartan and Sacubitril: MedlinePlus Drug Information. https://medlineplus.gov/druginfo/meds/a615039.html. Date Accessed September 29, 2026.