Entresto

NOTICE: This Consumer Medicine Information (CMI) is intended for persons living in Australia.

Consumer Medicine Information (CMI) summary
The full CMI on the next page has more details. If you are worried about using this medicine, speak to your doctor or pharmacist.

Why am I using Entresto?

Entresto contains the active ingredients sacubitril and valsartan. Entresto is used to treat a type of heart failure.
For more information, see Section 1. Why am I using Entresto? in the full CMI.

What should I know before I use Entresto?

Do not use if you have ever had an allergic reaction to Entresto or any of the ingredients listed at the end of the CMI. Do not take Entresto if you are pregnant, taking medicines similar to Entresto or have severe liver problems.
Talk to your doctor if you have any other medical conditions, take any other medicines, plan to become pregnant or are breastfeeding.
For more information, see Section 2. What should I know before I use Entresto? in the full CMI.

What if I am taking other medicines?

Some medicines may interfere with Entresto and affect how it works.
A list of these medicines is in Section 3. What if I am taking other medicines? in the full CMI.

How do I use Entresto?

Take one tablet in the morning and one tablet in the evening (your doctor will tell you what strength) either with food or without food.
More instructions can be found in Section 4. How do I use Entresto? in the full CMI.

What should I know while using Entresto?

Things you should do
Remind any doctor, dentist or pharmacist you visit that you are using Entresto.
Avoid becoming pregnant while using Entresto.
Things you should not do
Do not stop using this medicine suddenly.
Do not take another medicine for high blood pressure or heart failure from a class known as angiotensin converting enzyme inhibitor.
Driving or using machines
Entresto may cause dizziness or tiredness in some people.
Drinking alcohol
There are no known interactions between Entresto and alcohol.
Looking after your medicine
Store it in a cool dry place away from moisture, heat or sunlight.
For more information, see Section 5. What should I know while using Entresto? in the full CMI.

Are there any side effects?

Common side effects include: dizziness, fainting, light-headedness, cough, headache, diarrhoea, feeling sick, stomach pain, tiredness, weakness. Serious side effects include: swelling of the face, lips, tongue and/or throat and difficulty breathing and/or swallowing.
For more information, including what to do if you have any side effects, see Section 6. Are there any side effects? in the full CMI.
Active ingredient(s): sacubitril and valsartan
Consumer Medicine Information (CMI)
This leaflet provides important information about using Entresto. You should also speak to your doctor or pharmacist if you would like further information or if you have any concerns or questions about using Entresto.
Where to find information in this leaflet:

Why am I using Entresto?

Entresto is used to treat a type of heart failure in adults. Entresto has been shown to lower the risk of cardiovascular related deaths and heart failure related hospitalisation.
Entresto contains the active ingredients sacubitril and valsartan. It is an angiotensin receptor neprilysin inhibitor (ARNI), which contains two active ingredients: sacubitril (a neprilysin inhibitor), and valsartan (an angiotensin receptor blocker or ARB). Entresto works by blocking the changes caused by the enzyme neprilysin, and angiotensin-II. As a result, blood vessels relax and less water is kept by the body which is useful to treat heart failure.

What should I know before I use Entresto?

Warnings

Do not use Entresto if:
you are allergic to sacubitril or valsartan, or any of the ingredients listed at the end of this leaflet. Always check the ingredients to make sure you can use this medicine.
you are taking another medicine for high blood pressure or heart failure from a class known as angiotensin converting enzyme (ACE) inhibitor
you have taken another medicine containing an ACE inhibitor within the last 36 hours
you or someone in your family, have had a reaction before that causes swelling of the face, lips, tongue and/or throat, with or without difficulties in breathing while taking an ACE inhibitor or an ARB in the past.
you are taking a medicine called aliskiren and have Type 2 diabetes (high level of sugar in the blood)
you have severe liver disease.

Check with your doctor if you:

are already taking any medicine that is an ACE inhibitor or ARB
have low blood pressure
are taking other medicines that lower your blood pressure
have ever experienced swelling of the face, lips, tongue and/or throat, with or without difficulties in breathing
have kidney problems
have liver problems
are taking any medicines that increase the amount of potassium in your blood, or potassium supplements, salt substitutes that contain potassium, potassium-sparing medicines, or heparin
have any other medical condition.
During treatment, you may be at risk of developing certain side effects. It is important you understand these risks and how to monitor for them. See additional information under Section 6. Are there any side effects?

Pregnancy and breastfeeding

Do not take this medicine if you are pregnant or plan to become pregnant. If you become pregnant or think you are pregnant, tell your doctor right away.
Check with your doctor if you want to become pregnant.
Talk to your doctor if you are breastfeeding or intend to breastfeed.

Contraception

To avoid becoming pregnant, you should use contraception while using Entresto and for 1 week after you stop using it.

Use in children

It is not known whether Entresto is safe and effective in patients below 18 years.

What if I am taking other medicines?

Tell your doctor or pharmacist if you are taking any other medicines, including any medicines, vitamins or supplements that you buy without a prescription from your pharmacy, supermarket or health food shop.
Medicines not to be taken with Entresto include:
any medicine that is an angiotensin converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB)
Ask your doctor or pharmacist if you are unsure if you are being treated with these other medicines. ACE inhibitors and ARBs are sold under many different brand names in Australia.
Some medicines may interfere with Entresto. These include:
statins, a medicine used to lower cholesterol levels e.g. atorvastatin
sildenafil, a medicine used to treat erectile dysfunction and certain types of high blood pressure
medicines that increase the amount of potassium in the blood, including potassium sparing diuretics, a medicine used to reduce excess fluid in your body, e.g. amiloride
medicines used to treat pain and arthritis, called non-steroidal anti-inflammatory drugs (NSAID) or selective cyclo-oxygenase-2 inhibitors ( COX-2 ) inhibitors, e.g. ibuprofen
lithium, a medicine used to treat some types of depression
frusemide, a medicine used to reduce excess fluid in the body
metformin, a medicine used to control blood glucose for diabetes
some antibiotics, e.g. rifampicin, a medicine used to treat certain infections
ciclosporin, a medicine to treat certain problems with the immune system, or to help prevent organ transplant rejection
ritonavir, a medicine used to treat HIV/AIDS infection.
Tell your doctor if you take potassium supplements or salt substitutes that contain potassium.
Check with your doctor or pharmacist if you are not sure about what medicines, vitamins or supplements you are taking and if these affect Entresto.

How do I use Entresto?

How much to take

Your doctor will decide how many tablets you should take
The usual starting dose is one 49 mg/51 mg (pale yellow) tablet taken twice a day
Some patients will start at a lower dose
Your doctor will adjust the dose based on how you respond to treatment after 2 to 4 weeks until the best dose for you is found
Follow the instructions provided and use Entresto until your doctor tells you to stop.

When to take Entresto

Take one tablet in the morning and one tablet in the evening.

How to take Entresto

Swallow Entresto tablets whole.
Take Entresto either with food or without food.

If you forget to take Entresto

Entresto should be taken regularly at the same time each day. If you miss your dose at the usual time, take your dose as soon as you remember.
If it is almost time for your next dose, skip the dose you missed and take your next dose when you are meant to.
Do not take a double dose to make up for the dose you missed.

If you take too much Entresto

If you think that you have taken too much Entresto, you may need urgent medical attention. You may feel dizzy or lightheaded if you take too much Entresto.
You should immediately:
phone the Poisons Information Centre
(by calling 13 11 26), or
contact your doctor, or
go to the Emergency Department at your nearest hospital.
You should do this even if there are no signs of discomfort or poisoning.

What should I know while using Entresto?

Things you should do

Call your doctor straight away if you:

show signs of swelling of the face, lips, tongue and/or throat, and difficulty in breathing
become pregnant while taking Entresto.
Remind any doctor, dentist or pharmacist you visit that you are using Entresto.
Keep all appointments with your doctor so your progress can be checked regularly. Your doctor may want to check your kidney function, blood cell counts, blood pressure, sugar and potassium levels.

Things you should not do

Do not stop using this medicine suddenly.
Do not take ACE inhibitors at the same time as this medicine.

Driving or using machines

Be careful before you drive or use any machines or tools until you know how Entresto affects you.
Entresto may cause dizziness or tiredness in some people.

Drinking alcohol

Be careful drinking alcohol until you know how this medicine affects you.

Looking after your medicine

Follow the instructions on the carton on how to take care of your medicine properly.
Store it in a cool dry place away from moisture, heat or sunlight; for example, do not store it:
in the bathroom or near a sink, or
in the car or on window sills.
Keep it where young children cannot reach it.

Getting rid of any unwanted medicine

If you no longer need to use this medicine or it is out of date, take it to any pharmacy for safe disposal.
Do not use this medicine after the expiry date.

Are there any side effects?

All medicines can have side effects. If you do experience any side effects, most of them are minor and temporary. However, some side effects may need medical attention.
See the information below and, if you need to, ask your doctor or pharmacist if you have any further questions about side effects.

Less serious side effects

Less serious side effects
What to do
Gut side effects:
Constipation
Diarrhoea
Feeling sick, vomiting
Stomach pain
Infections:
Flu-like symptoms such as fever, sore throat, cough, chills
Runny nose, blocked nose
Burning sensation when urinating
Urinating more frequently
General side effects:
Dizziness
Light-headed, feeling faint
dizziness when moving from sitting or lying down to a standing position
Tiredness
Headache
Weakness
Trouble sleeping
Back pain, joint pain
Speak to your doctor if you have any of these less serious side effects and they worry you.
If these side effects become severe, please tell your doctor, pharmacist, or health care provider

Serious side effects

Serious side effects
What to do
Chest pain, feeling of tightness or pressure in the chest
Fast heart beat
Shortness of breath
Swelling of the feet, ankles or hands
Wheezing, trouble breathing, persistent cough
Call your doctor straight away, or go straight to the Emergency Department at your nearest hospital if you notice any of these serious side effects.
Severe allergic reaction signs:
Swollen face, tongue, lips or throat
Difficulty in swallowing
Difficulty in breathing
Rash, itching.
Stop taking Entresto and call your doctor straight away, or go to the Emergency Department at your nearest hospital if you notice any signs of an allergic reaction.
Tell your doctor or pharmacist if you notice anything else that may be making you feel unwell.
Other side effects not listed here may occur in some people.
Some side effects (for example problems with kidneys, low red blood cells, low sugar levels in the blood, high or low levels of potassium in the blood, low blood pressure) can only be found when your doctor does tests from time to time to check your progress.

Reporting side effects

After you have received medical advice for any side effects you experience, you can report side effects to the Therapeutic Goods Administration online at www.tga.gov.au/reporting-problems . By reporting side effects, you can help provide more information on the safety of this medicine.
Always make sure you speak to your doctor or pharmacist before you decide to stop taking any of your medicines.

Product details

This medicine is only available with a doctor's prescription.

What Entresto contains

Active ingredients
(main ingredients)
Sacubitril
Valsartan
Other ingredients
(inactive ingredients)
microcrystalline cellulose
hydroxypropylcellulose
crospovidone
magnesium stearate (of vegetable origin)
colloidal anhydrous silica
purified talc
The film-coating on the tablets contain:
hypromellose
macrogol 4000
purified talc
titanium dioxide
iron oxide red
iron oxide black (in the 24 mg/26 mg and 97 mg/103mg tablets only)
iron oxide yellow (in the 49 mg/51mg tablets only)
Potential allergens
None
Entresto does not contain lactose, gluten, tartrazine or any other azo dyes.
Do not take this medicine if you are allergic to any of these ingredients.

What Entresto looks like

Entresto is supplied as film-coated tablets and is available in 3 different strengths:
24 mg/26 mg: violet-white, ovaloid biconvex film-coated tablets with bevelled edges, unscored, debossed with "NVR" on one side and "LZ" on the other side; AUST R 234219.
49 mg/51 mg: are pale yellow ovaloid biconvex film-coated tablets with bevelled edges, unscored, debossed with "NVR" on one side and "L1" on the other side; AUST R 234222.
97 mg/103 mg: light pink ovaloid biconvex film-coated tablets with bevelled edges, unscored, debossed with "NVR" on one side and "L11" on the other side; AUST R 234218.
Entresto is packed in blister packs containing 14, 28, 56 or 60 tablets per carton.
Some pack sizes may not be marketed.

Who distributes Entresto

Entresto is supplied in Australia by:
Novartis Pharmaceuticals Australia Pty Limited
(ABN 18 004 244 160)
54 Waterloo Road
Macquarie Park NSW 2113
Telephone 1 800 671 203
This leaflet was prepared in March 2022.
Internal document code:
ent291122c based on PI ent291122i