![]() ![]() Several cases described a washout period of less than 36 hours when switching from an ACE inhibitor to Entresto. ![]() The cases submitted to FDA describe patients who were taking an ACE inhibitor and were prescribed Entresto, and patients who started taking Entresto in the hospital and inadvertently restarted their ACE inhibitor after discharge. ![]() Still, the US Food and Drug Administration (FDA) has received 55 cases reporting concomitant use of Entresto and an ACE inhibitor, with several cases describing serious outcomes. Thus, Entresto should not be administered within 36 hours of switching from or to an ACE inhibitor. 1 Also, the dual renin-angiotensin-aldosterone system blockade that occurs when valsartan is combined with ACE inhibitors increases the risk of hypotension, acute kidney injury, and hyperkalemia. Entresto is contraindicated with concomitant use of angiotensin converting enzyme (ACE) inhibitors because the inhibition of neprilysin from the sacubitril component in Entresto combined with an ACE inhibitor increases the risk of angioedema. It contains the angiotensin II receptor blocker (ARB) valsartan and the neprilysin inhibitor sacubitril. PROBLEM: ENTRESTO (sacubitril/valsartan) is an angiotensin II receptor-neprilysin inhibitor (ARNI) used to reduce the risk of cardiovascular death and hospitalization in patients with chronic heart failure and reduced ejection fraction. ![]()
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