Angiotensin receptor neprilysin inhibitors (ARNIs)

ARNIs are used to treat heart failure. Currently, the only ARNI available in New Zealand is Entresto (sacubitril/valsartan). Learn how Entresto works and the possible side effects.

Types of ARNIs

• sacubitril and valsartan, also called Entresto

Entresto is made up of two medications (sacubitril and valsartan) combined into one tablet.

How does Entresto work?

Entresto is used to treat heart failure. Entresto reduces excess fluid in your body and relaxes blood vessels, making it easier for your heart to pump blood around your body.

It helps relieve symptoms such as:

• tiredness
• breathlessness
• fluid build-up.

Over time Entresto has been shown to improve your ejection fraction, which measures how well your heart pumps blood.

Side effects of Entresto

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

• headache
• feeling dizzy or light-headed
• feeling sick (nausea) and being sick (vomiting)
• runny poo (diarrhoea).

Call 111 if you have signs of an allergic reaction including:

• itchy skin and rash
• swollen lips or tongue
• breathing problems, such as a tight chest or shortness of breath.

Talk to your doctor if the side effects are worrying you or they don’t go away after a few weeks. 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 check:

• kidney function and potassium
• liver function.

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

What if I miss a dose of Entresto?

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, if you are taking an ACE inhibitor you will need to stop this 36 hours before starting Entresto. This is because the risk of a severe angioedema (a dangerous rapid swelling of the face, lips and tongue or throat which can block breathing) dramatically increases if both tablets are taken too close together.  

This is not the case if switching from an angiotensin receptor blocker (ARB) medication to Entresto. 

Check with your doctor:

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

Avoid taking NSAIDs (non-steroidal anti-inflammatory drugs) like ibuprofen (e.g. Nurofen) and diclofenac (e.g. Voltaren) when you’re taking Entresto.

Tell your doctor if you’re taking any:

• vitamins
• supplements
• natural medicines
• medicines bought from a pharmacy without a prescription
• alternative therapies.

These can sometimes make your heart medications 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

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