If you have heart failure, your doctor might suggest Entresto as a treatment option for you.

Entresto is a prescription drug that’s used to:

  • reduce the risk of hospitalization and death in adults with certain kinds of heart failure
  • treat certain kinds of heart failure in some children

Entresto contains the active ingredients sacubitril and valsartan. (An active ingredient is what makes a drug work.)

For more information about Entresto, including details about its uses, see this in-depth article on the drug.

Like other drugs, Entresto can cause mild to serious side effects. Keep reading to learn more.

Some people may experience mild to serious side effects during their Entresto treatment. Examples of Entresto’s commonly reported side effects include:

* To learn more about this side effect, see the “Side effects explained” section below.

Entresto may cause mild side effects. Examples of mild side effects that have been reported with Entresto include:

* To learn more about this side effect, see the “Side effects explained” section below.

In most cases, these side effects should be temporary. And some may be easily managed. But if you have any symptoms that are ongoing or bother you, talk with your doctor or pharmacist. And do not stop taking Entresto unless your doctor recommends it.

Entresto may cause mild side effects other than the ones listed above. See the drug’s prescribing information for details.

Serious side effects are possible with Entresto. Serious side effects that have been reported with Entresto include:

If you develop serious side effects while taking Entresto, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

* To learn more about this side effect, see the “Side effects explained” section below.
† Entresto has a boxed warning for this side effect. To learn more, see “Pregnancy while taking Entresto” under the “Warnings for Entresto” section below.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Entresto, visit MedWatch.

Get answers to some frequently asked questions about Entresto’s side effects.

Are there patient reviews about the side effects of Entresto?

The Entresto website has videos with first-hand stories from people who take Entresto. You can hear about their experience with the drug.

If you have questions or concerns about the side effects of Entresto, talk with your doctor. Ask if they can share what other patients have experienced while taking Entresto.

Can Entresto cause different side effects in older adults than in others taking the drug?

No, Entresto should have the same side effects when used in older adults (ages 65 years and older). In studies of Entresto, there weren’t any reported differences in side effects between older adults and younger adults.

If you have questions or concerns about taking Entresto based on your age, talk with your doctor.

Is weight gain a side effect of Entresto?

No, Entresto isn’t known to cause weight gain. This wasn’t a side effect reported in studies of the drug. But it’s important to monitor your weight if you have heart failure. (Entresto is used in certain people with heart failure.) Gaining weight could be a sign that heart failure is getting worse.

If you have any sudden weight gain, tell your doctor as soon as possible. Also, let your doctor know if you notice any swelling in your feet, ankles, lower legs, or belly.

Does Entresto cause itching or shortness of breath?

Itching and shortness of breath are not direct side effects of Entresto. But they’re both possible symptoms of an allergic reaction, which can occur with Entresto.

Itching tends to happen with mild allergic reactions. Shortness of breath is more likely to happen with a severe allergic reaction. To learn more about allergic reactions, see the “Side effects explained” section below.

Shortness of breath can also be a sign that heart failure is getting worse. (Entresto is used in certain people with heart failure.)

If you have itching or shortness of breath while taking Entresto, tell your doctor. But if your symptoms feel life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

If I take Entresto, will I experience hair loss?

No, Entresto shouldn’t cause hair loss. This wasn’t a side effect reported in studies of the drug.

But other medications that treat heart problems may cause hair loss in rare cases. This includes angiotensin converting enzyme (ACE) inhibitors and beta-blockers.

If you experience hair loss that concerns you, talk with your doctor. They can determine what the most likely cause of hair loss is and suggest ways to manage it.

Learn more about some of the side effects Entresto may cause.

High potassium level

Some people may develop a high potassium level in the blood while taking Entresto. This was a common side effect in studies of the drug.

If your potassium level is mildly high, you’re unlikely to have side effects. But a very high potassium level can cause symptoms, including:

What might help

Your doctor may want to monitor your potassium level while you’re taking Entresto. A mildly high level usually isn’t reason for concern. But if you have any of the symptoms listed above, call your doctor right away.

If your symptoms feel life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Kidney problems

Entresto may cause kidney problems. This was a common side effect reported in studies of the drug. In some cases, these problems can lead to kidney failure.

Kidney failure can cause symptoms such as:

  • confusion
  • producing only a small amount of urine
  • itchy or dry skin
  • nausea
  • swelling in the feet, ankles, or lower legs

What might help

Your doctor may monitor your kidney function during your Entresto treatment. If you experience any of the symptoms of kidney failure listed above, tell your doctor right away.

If tests show that your kidneys aren’t working as well as they should, your doctor may need to lower your dose of Entresto. In some cases, your doctor may have you stop taking Entresto temporarily while they treat your kidney problem.

If you’re concerned about kidney problems with Entresto, talk with your doctor before starting treatment.

Low blood pressure

Entresto can cause low blood pressure. In studies of the drug, this was the most common side effect.

Symptoms of low blood pressure can include:

Fainting or feeling dizzy or lightheaded can lead to falls, which were also reported in the studies of Entresto.

What might help

If you experience any of the symptoms of low blood pressure listed above, let your doctor know. They may lower your Entresto dose. If you take any other medications that affect blood pressure, your doctor may adjust your dosage of those drugs as well.

Allergic reaction

Like most drugs, Entresto can cause an allergic reaction in some people. Symptoms can be mild to serious and can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)
  • shortness of breath
  • swelling under your skin, usually in your eyelids, lips, hands, or feet
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms. Examples include:

  • an antihistamine you take by mouth, such as Benadryl (diphenhydramine)
  • a product you apply to your skin, such as hydrocortisone cream

If your doctor confirms you’ve had a mild allergic reaction to Entresto, they’ll decide whether you should continue using it.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to Entresto, they may have you switch to a different treatment.

Keeping track of side effects

During your Entresto treatment, consider taking notes on any side effects you’re having. You can then share this information with your doctor. This is especially helpful when you first start taking new drugs or using a combination of treatments.

Your side effect notes can include things such as:

  • what dose of the drug you were taking when you had the side effect
  • how soon you had the side effect after starting that dose
  • what your symptoms were
  • how your symptoms affected your daily activities
  • what other medications you were taking
  • any other information you feel is important

Keeping notes and sharing them with your doctor will help them learn more about how Entresto affects you. They can then use this information to adjust your treatment plan if needed.

Entresto comes with several warnings, including a boxed warning.

Boxed warning: Risk of fetal harm

Entresto has a boxed warning for the risk of fetal harm if taken during pregnancy. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).

To learn more, see the “Pregnancy while taking Entresto” section below.

Other warnings

Entresto may not be right for you if you have certain medical conditions. These are known as drug-condition interactions. Other factors may also affect whether Entresto is a good treatment option for you.

Talk with your doctor about your health history before starting Entresto. Factors to consider include those described below.

Angioedema. Certain people are more likely to develop angioedema when taking Entresto. This includes people who have had angioedema while taking an angiotensin converting enzyme (ACE) inhibitor or angiotensin II receptor blocker. If you’ve had angioedema after taking one of these medications before, ask your doctor about other treatment options.

ACE inhibitor treatment. Taking an ACE inhibitor with Entresto increases your risk of angioedema. Due to this risk, doctors usually don’t prescribe Entresto for people who also take an ACE inhibitor.

When switching from an ACE inhibitor to Entresto, doctors usually recommend waiting 36 hours after stopping the ACE inhibitor before taking Entresto. Ask your doctor or pharmacist if you aren’t sure whether you take an ACE inhibitor.

Allergic reaction. If you’ve had an allergic reaction to Entresto or any of its ingredients, your doctor will likely not prescribe Entresto. Ask them what other medications are better options for you.

Diabetes. For people with diabetes, taking the drug aliskiren (Tekturna) with Entresto increases the risk of kidney problems. People with diabetes should not take these two drugs together. If you have diabetes and take aliskiren, talk with your doctor about treatment options other than Entresto.

Liver problems. Taking Entresto if you have a severe liver problem (such as cirrhosis) is not recommended. Instead, your doctor can suggest other treatments that may be safer for you.

If you have a moderate liver problem, your doctor will likely prescribe a lower Entresto dosage. Talk with your doctor to learn more about the severity of any liver problems you have and whether Entresto is safe for you to take.

Severe liver disease. Taking Entresto if you have severe liver disease is not recommended. If you have liver disease, talk with your doctor. Ask whether Entresto is right for you and about other treatment options you have.

Alcohol and Entresto

There’s no known interaction between alcohol and Entresto. But alcohol can cause some of the same side effects as Entresto. Examples include dizziness and changes in blood pressure. Combining Entresto with alcohol can raise your risk of having these side effects, or it can worsen the side effects that you experience.

Alcohol can also make heart failure worse. Entresto is used in certain people with heart failure.

If you drink alcohol, talk with your doctor about how much (if any) may be safe to consume with your condition and treatment plan.

Pregnancy while taking Entresto

You should not take Entresto during pregnancy. Entresto has a boxed warning for the risk of fetal harm if taken during pregnancy. (A boxed warning is a serious warning from the FDA.)

Taking Entresto during pregnancy can cause harm to a fetus or pregnancy loss. If you become pregnant while taking Entresto, tell your doctor immediately and stop taking the drug as soon as possible.

If you can become pregnant, talk with your doctor about using birth control while taking Entresto.

Breastfeeding while taking Entresto

Taking Entresto while breastfeeding is not recommended. It’s not known whether the drug passes into breast milk or what effects it could have on a child who is breastfed. But because of the risk of serious side effects, your doctor will likely recommend that you do not take this drug while breastfeeding.

If you’re breastfeeding or planning to breastfeed, talk with your doctor before taking Entresto.

If you still have questions about the possible side effects of Entresto, talk with your doctor. They can help you determine whether this drug is right for you.

Examples of questions you may want to ask include:

  • How do Entresto’s side effects compare with those of other drugs that can treat my condition?
  • How long do the side effects of Entresto usually last?
  • What can I do to prevent or manage common side effects of Entresto?

To learn more about Entresto, see these articles:

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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.