Sacubitril — what it is and when it's used

Sacubitril is a medicine used together with valsartan in a combo often called sacubitril/valsartan or by the brand name Entresto. Doctors prescribe it for people with heart failure with reduced ejection fraction (HFrEF). That means the heart pumps less blood than it should. Clinical trials showed this combo lowers the risk of hospital visits and death compared with older standard therapy. If you or a loved one has HFrEF, sacubitril is worth discussing with your cardiologist.

How sacubitril works

Sacubitril blocks an enzyme called neprilysin. That raises levels of helpful peptides that relax blood vessels and reduce fluid build-up. Valsartan blocks the angiotensin receptor, which lowers blood pressure and eases strain on the heart. Together they reduce stress on the heart more than either drug alone. The result: the heart pumps better and symptoms like shortness of breath and swelling often improve.

Practical tips & safety

Start with the basics before taking sacubitril/valsartan. Get baseline blood tests: kidney function and potassium. Check your blood pressure often, especially during the first weeks. Low blood pressure, high potassium, and worsening kidney function are the main problems to watch for. If you already take an ACE inhibitor, stop it at least 36 hours before starting sacubitril/valsartan to avoid dangerous swelling of the face or throat (angioedema). Tell your doctor about all medicines you take. Potassium supplements, potassium-sparing diuretics, and some blood pressure drugs can raise potassium too much.

Common side effects include lightheadedness, cough, and high potassium. Severe angioedema is rare but needs emergency care. Pregnant people should not take sacubitril/valsartan due to serious risks to the fetus. Older adults may need lower starting doses because they can be more sensitive to low blood pressure and kidney changes.

Do you feel dizzy or faint after a dose? Sit or lie down and check your blood pressure. Call your provider if you have swelling of the face, lips, tongue, or throat, or if you pass little urine. For mild side effects, your doctor may lower the dose or change other medicines first.

Cost can be a concern. Manufacturer savings cards, insurance prior authorization, or generic options for the valsartan component can help. Never buy prescription meds from sites that don’t require a prescription. Use licensed pharmacies and keep a copy of your prescription and lab results.

Want to read more? Look for trusted pages that explain dosing, monitoring, and how sacubitril/valsartan compares to older heart failure drugs. Bring notes to appointments and ask for a clear plan: what to check, when to call, and what to do if side effects start. That makes treatment safer and more effective.