Entresto Dosage/Direction for Use

sacubitril + valsartan




The information highlighted (if any) are the most recent updates for this brand.
Full Prescribing Info
Dosage/Direction for Use
The recommended starting dose of Entresto is one tablet of 100 mg twice daily, except in the situations described below. The dose should be doubled at 2-4 weeks to the target dose of one tablet of 200 mg twice daily, as tolerated by the patient (see Pharmacology: Pharmacodynamics under Actions).
If patients experience tolerability issues (systolic blood pressure [SBP] ≤95 mmHg, symptomatic hypotension, hyperkalaemia, renal dysfunction), adjustment of concomitant medicinal products, temporary down–titration or discontinuation of Entresto is recommended (see Precautions).
In PARADIGM-HF study, Entresto was administered in conjunction with other heart failure therapies, in place of an ACE inhibitor or other angiotensin II receptor blocker (ARB) (see Pharmacology: Pharmacodynamics under Actions). There is limited experience in patients not currently taking an ACE inhibitor or an ARB or taking low doses of these medicinal products, therefore a starting dose of 50 mg twice daily and slow dose titration (doubling every 3-4 weeks) are recommended in these patients (see “Titration” in Pharmacology: Pharmacodynamics under Actions).
Treatment should not be initiated in patients with serum potassium level >5.4 mmol/L or with SBP <100 mmHg (see Precautions). A starting dose of 50 mg twice daily should be considered for patients with SBP ≥100 to 110 mmHg.
Entresto should not be co-administered with an ACE inhibitor or an ARB. Due to the potential risk of angioedema when used concomitantly with an ACE inhibitor, it must not be started for at least 36 hours after discontinuing ACE inhibitor therapy (see Precautions, Contraindications and Interactions).
The valsartan contained within Entresto is more bioavailable than the valsartan in other marketed tablet formulations (see Pharmacology: Pharmacokinetics under Actions).
If a dose is missed, the patient should take the next dose at the scheduled time.
Special Populations: Elderly Population: The dose should be in line with the renal function of the elderly patient.
Renal Impairment: No dose adjustment is required in patients with mild (Estimated Glomerular Filtration Rate [eGFR] 60-90 mL/min/1.73 m2) renal impairment. A starting dose of 50 mg twice daily should be considered in patients with moderate renal impairment (eGFR 30-60 mL/min/1.73 m2). As there is very limited clinical experience in patients with severe renal impairment (eGFR <30 mL/min/1.73 m2) (see Pharmacology: Pharmacodynamics under Actions) Entresto should be used with caution and a starting dose of 50 mg twice daily is recommended. There is no experience in patients with end-stage renal disease and use of Entresto is not recommended.
Hepatic Impairment: No dose adjustment is required when administering Entresto to patients with mild hepatic impairment (Child-Pugh A classification). There is limited clinical experience in patients with moderate hepatic impairment (Child-Pugh B classification) or with AST/ALT values more than twice the upper limit of the normal range. Entresto should be used with caution in these patients and the recommended starting dose is 50 mg twice daily (see Pharmacology: Pharmacokinetics under Actions and Precautions). Entresto is contraindicated in patients with severe hepatic impairment, biliary cirrhosis or cholestasis (Child-Pugh C classification) (see Contraindications).
Paediatric Population: The safety and efficacy of Entresto in children and adolescents aged below 18 years have not been established. No data are available.
Administration: Oral use.
Entresto may be administered with or without food (see Pharmacology: Pharmacokinetics under Actions). The tablets must be swallowed with a glass of water.
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