Angiotensin receptor-neprilysin inhibitors (ARNIs)


Transitioning to an ARNI? Here's what you need to know.


Drug class: angiotensin receptor–neprilysin inhibitor (ARNI)

Generic (Brand) names: sacubitril/valsartan (Entresto)

In heart failure, the weakened heart cannot send a sufficient supply of oxygen- and nutrient-rich blood throughout the body.

This drug reduces strain on the heart by relaxing blood vessels, lowering blood pressure, and reducing sodium and fluid buildup in the body.

This drug has been shown to reduce death and heart failure hospitalization compared with ACE inhibitors. It is often used in place of ACE inhibitors or ARB’s.

Side effects may include:

  • Low blood pressure
  • Dizziness, lightheadedness, or fainting
  • High levels of potassium in the blood
  • Worsening kidney function
  • Angioedema, a rapid swelling in the face, neck, or tongue. This can be serious. Tell your provider immediately if it occurs.

Your provider will have told you what dose of this medication to take, and how many times per day to take it. The label on your medication bottle should also indicate how many pills to take, and how often.

Over time, your provider may adjust your dose.

Make sure the dose you need to take matches the strength of the tablets in your bottle. If the strength of your tablet does not match the dose you have been prescribed, you may need to split the pill and have only part of it, or take more than one pill. Always remember to consult your provider if you are unclear about what your most recent dose of ARNI is.

Take this medication at the same time every day, with or without food.

Tell your provider if you experience side effects. He or she may be able to adjust your dose or switch you to a different combination of medications.

This drug should not be taken with an ACE inhibitor. If you have been prescribed this drug and are taking an ACE inhibitor, speak with your provider about how to make the switch.

Your provider may ask you to monitor your blood pressure at home to make sure it is not too low.

You may also need blood tests to check your potassium levels and kidney function.

You may not feel different in the short term if you do not take this medication as directed. Over time, you will feel worse and be at greater risk for hospitalization. In addition, you heart failure will continue to progress.