Angiotensin receptor neprilysin inhibitors (ARNIs)

ARNIs are a type of medication used to treat heart failure. Currently the only ARNI available in New Zealand is Entresto (valsartan/sacubitril). Learn how Entresto works and about its side effects.

Types of ARNI

  • valsartan/sacubitril, also called Entresto

Entresto is given to people with heart failure. It helps relieves symptoms such as:

  • tiredness
  • breathlessness
  • fluid build-up.

How does it work?

Entresto reduces excess fluid in your body and relaxes blood vessels, which makes it easier for your heart to pump blood around your body.

Over time it has been shown to improve ejection fraction (the measurement of your heart's pumping function).

Side effects

You may experience some unwanted effects when taking Entresto. These can include:

  • headache
  • nausea (feeling sick)
  • vomiting (being sick)
  • diarrhoea (runny poos)
  • rash or itchiness.

Ring 111 if you have any of the following:

  • severe chest pain
  • severe headache
  • sudden shortness of breath
  • swelling of your mouth, lips or tongue, as this could be an allergic reaction.

Talk to your doctor if your side effects are worrying you. Don't stop taking your medication without talking to your doctor first. The benefit usually outweighs the side effects.

What checks do I need?

Before you start this medication your doctor may order blood tests to review: 

  • kidney function
  • liver function.

Your doctor will monitor your progress on this medication and adjust the dose if necessary. You will have regular blood tests to monitor kidney function and potassium.  

What happens if I miss a dose?

It's important to take your medication daily and not to skip a dose. 

If you forget to take a dose, take it immediately, then continue as normal the following day. However, if it's almost time for the next dose, skip the missed dose and continue as normal. 

Do NOT take a double dose.

What else do I need to know?

Before you start taking Entresto, you will have to stop taking your ACE inhibitor (another of your heart medications).

Check with your health professional: 

  • which medication you are stopping 
  • when to start taking Entresto and at what dose.   

Avoid taking NSAIDs (non-steroidal anti-inflammatory drugs) like ibuprofen, nurofen and  voltaren when you're taking Entresto.

Tell your health professionals if you're taking any:

  • supplement 
  • natural medicines
  • vitamins
  • alternative therapies. 

These can sometimes make your heart medication less effective. 

Talk to your doctor if you're planning to get pregnant or are breastfeeding.

Don't stop taking your medication, even if you're feeling better.

Related treatments and conditions

Heart failure

Search for another heart medication