An estimated 6.2 million people in the United States have experienced heart failure. This potentially life threatening condition means the heart cannot pump enough blood and oxygen to organs throughout the body.

Entresto is one of the drugs doctors may prescribe for heart failure.

This article details how Entrestro works, the potential side effects, and how effective it may be.

Entresto is part of a group of medications known as angiotensin receptor-neprilysin inhibitors (ARNIs). This medication is a combination of two types of medications commonly prescribed to treat heart failure:

Valsartan is an ARB that blocks angiotensin II receptors throughout the body to decrease blood pressure. It can also help prevent kidney damage that frequently occurs with heart failure.

The other medication is sacubitril, a neprilysin inhibitor that causes blood vessels to dilate.

The Food and Drug Administration (FDA) cleared Entrestro in February 2021 to treat individuals with heart failure with preserved ejection fraction.

It was previously approved for heart failure with reduced ejection fraction, sometimes called systolic heart failure. This occurs when the heart’s left ventricle becomes enlarged and fails to properly push blood into the circulatory system.

What is ejection fraction in the heart?

Ejection fraction is the measurement term for how much blood leaves the heart ventricle every time it pumps. The more blood that is pumped out, the healthier the heart is.

According to the American Heart Association (AHA), a 50% to 70% ejection fraction is normal. An ejection fraction below 40% can indicate heart failure or cardiomyopathy.

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Medications are one way doctors try to increase the heart’s ejection fraction. They can help widen blood vessels and reduce blood pressure. Some can even help address the damaging effects of stress hormones on the heart.

Studies have shown that Entresto is effective at improving ejection fraction. It is frequently given with other heart failure medications in place of an ACE inhibitor or ARB.

Entresto is approved for treating symptomatic heart failure in adults and children at least 1 year old.

Dosage may be modified depending on weight.

Side effects seem to occur to a similar degree in children and adults, but studies into the safety of Entresto in children are ongoing. No significant differences have been noted in giving Entresto to older people.

Your doctor may not recommend Entresto for these reasons:

  • You are pregnant.
  • You take an ACE inhibitor.
  • You have a history of severe swelling beneath the skin called angioedema.
  • You are hypersensitive to sacubitril, valsartan, or the combination of the two.
  • You live with diabetes and are also taking a renin inhibitor called Tekturna.

Entresto can have side effects. Some of the more common side effects include:

  • coughing
  • dizziness

More serious side effects include:

The FDA has offered a box warning against using Entresto if you are pregnant. The drug may harm the baby’s kidneys.

If serious side effects occur while using Entresto, contact your doctor and seek immediate medical help.

Studies have shown that Entresto may reduce the need for hospitalizations for those with heart failure. It has also been linked with a decrease in cardio-related deaths.

It’s important to note that many factors can influence the expected lifespan of someone with heart failure. For example, other conditions such as kidney disease and the degree of heart failure before treatment can all impact lifespan.

Ejection fraction in the heart may be improved with:

  • Beta-blockers: These medications can slow heart rate and reduce blood pressure. They can also help reduce the effects of stress hormones like adrenaline on the heart. Carvedilol, metoprolol, and bisoprolol are examples of beta-blockers that may be used to treat heart failure.
  • ACE inhibitors: These drugs can help blood vessels relax and open. They limit the formation of angiotensin II.
  • ARBs: As an alternative to ACE inhibitors, ARBs block certain receptors of angiotensin II. This also causes blood vessels to relax and open. Valsartan and losartan are examples of ARBs that might be prescribed for heart failure.
  • Neprilysin inhibitors: These drugs increase the availability of natriuretic peptides. They can help dilate blood vessels and expel sodium. They can also reduce blood pressure. Sacubitril is an example of a Neprilysin inhibitor used to treat heart failure.

Though they will not necessarily improve your heart’s ejection fraction, prescription diuretics help with some heart failure symptoms.

How long does it take Entresto to work?

Entresto takes between 30 minutes and 2 hours to reach peak absorption. With a twice-a-day dosage, steady levels can be achieved in 3 days.

How much can Entresto increase your ejection fraction?

The PROVE-HF trial showed a median increase in left ventricular ejection fraction from 28.2% to 37.8% at 12 months. A significant 5.2% increase was seen in 6 months.

How can you improve ejection fraction naturally?

Lifestyle changes can help improve ejection fraction. This includes reducing stress and salt intake. Also, increasing movement via daily walks can help. It’s also important not to partake in activities that may injure the heart, such as drinking excess alcohol or smoking.

Entresto is a medication that may help those with heart failure. It can be prescribed to help improve the heart’s ejection fraction.

Although the FDA has approved this medication, side effects are possible. In rare cases, serious complications such as kidney failure and fetal toxicity can occur. Before starting any medication, discuss the potential side effects with your doctor. A severe reaction to any medication is a medical emergency. Call 911 or seek care from a local hospital.