Entresto: A Game-Changer in the Fight Against Heart Failure
Heart failure is a chronic condition where the heart muscle can't pump enough blood to meet the body's needs. While managing it often involves lifestyle changes and a combination of medications, a drug called Entresto has emerged as a significant advancement, offering new hope for many patients.
If you or a loved one are navigating a heart failure diagnosis, you've likely heard of this medication. Here's a closer look at what Entresto is, how it works, and why it's considered a breakthrough.
What is Entresto?
Entresto is a brand-name prescription medication approved primarily to treat chronic heart failure with reduced ejection fraction (HFrEF) in adults. It's a combination drug containing two active ingredients:
- Sacubitril: This component is a neprilysin inhibitor. Neprilysin is an enzyme that breaks down beneficial peptides in the body that naturally help to relax blood vessels, reduce sodium retention, and decrease strain on the heart. By blocking this enzyme, sacubitril boosts the levels of these heart-friendly peptides.
- Valsartan: This is an angiotensin II receptor blocker (ARB). It blocks the effects of a hormone called angiotensin II, which typically causes blood vessels to narrow and raises blood pressure.
This dual mechanism of action—enhancing the good and blocking the bad—is what makes Entresto a powerful tool in heart failure management. It's an example of a class of drugs known as an Angiotensin Receptor-Neprilysin Inhibitor (ARNI).
How Does it Help the Heart?
By working in two ways, Entresto essentially helps to reduce the workload on the failing heart and improve its efficiency:
- Relaxing Blood Vessels: Both sacubitril and valsartan contribute to widening blood vessels, which lowers blood pressure and makes it easier for the heart to pump blood.
- Reducing Fluid & Salt Retention: By increasing beneficial peptides, the medication helps the body excrete excess salt and water, which reduces fluid buildup (edema, or swelling) and eases congestion in the heart and lungs.
- Preventing Heart Remodeling: Over time, heart failure can cause the heart muscle to change shape (remodeling), which worsens the condition. Entresto helps to counter these changes.
Clinical studies have shown that Entresto significantly reduces the risk of cardiovascular death and hospitalization for heart failure compared to traditional ACE inhibitors in many patients with HFrEF.
Important Things to Know
Like any powerful medication, there are important considerations when taking Entresto:
1. Common Side Effects
The most common side effects are often related to its action on blood pressure and include:
- Low blood pressure (hypotension): This can cause dizziness or lightheadedness, especially when standing up too quickly.
- Cough
- High potassium levels (hyperkalemia)
- Kidney problems
Your doctor will monitor your blood pressure, kidney function, and potassium levels through regular blood tests, especially when you start the medication.
2. Serious Warning: Angioedema
A rare but serious side effect is angioedema, a severe allergic reaction that causes swelling of the face, lips, tongue, or throat and can lead to trouble breathing. If you experience any signs of angioedema, seek emergency medical attention immediately and stop taking the medication.
3. The 36-Hour Rule
Entresto must not be taken with or within 36 hours of taking an ACE inhibitor (another class of heart failure medication) due to the increased risk of angioedema. Your doctor will carefully transition you from an ACE inhibitor if needed.
4. Pregnancy Warning
Entresto carries a Boxed Warning because it can harm or cause death to an unborn baby. It should not be used during pregnancy, particularly in the second and third trimesters.
The Bottom Line
Entresto represents a major step forward in the treatment of heart failure, providing superior benefits for many patients with reduced ejection fraction. Its dual mechanism offers a comprehensive way to manage a complex disease.
If you have heart failure, talk to your cardiologist. They can determine if Entresto is the right part of your treatment plan, discuss the potential risks, and monitor your progress as you work together toward a healthier future.