Entresto Dosage: Forms, Strengths, How to Use, and More
Entresto (sacubitril and valsartan) is prescribed to treat certain types of heart failure. The drug comes as tablets to swallow and capsules to open and sprinkle on food. You usually take it twice daily.
Entresto is used for the following:
- in adults with long-lasting heart failure to help reduce the risk of hospitalization and death
- in children ages 1 year and older with heart failure that’s causing symptoms
The active ingredients in Entresto are sacubitril and valsartan. Sacubitril belongs to a group of drugs called neprilysin inhibitors. Valsartan belongs to a group called angiotensin II receptor blockers.
This article describes the dosages of Entresto, as well as its strengths and how to take it. To learn more about Entresto, see this in-depth article.
Entresto and Entresto Sprinkle are different forms of the same drug. In this article, we refer to both as “Entresto” unless noted otherwise.
Boxed warning: Risk of fetal harm
Entresto has a boxed warning about the risk of fetal harm. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about drug effects that may be dangerous.
Taking Entresto during pregnancy can cause harm to a fetus or a pregnancy loss. Due to this risk, doctors usually will not prescribe Entresto during pregnancy. They’ll usually stop the drug as soon as possible if pregnancy occurs.
To learn more about this boxed warning, talk with your doctor.
What is Entresto’s dosage?
This section describes the usual dosages of Entresto. Keep reading to learn more.
What are Entresto’s forms?
Entresto comes as an oral tablet.
Entresto Sprinkle comes as a capsule that contains pellets. You empty the contents of a capsule onto a small amount of soft food.
What strengths does Entresto come in?
Entresto comes in three strengths:
- 24 milligrams (mg) of sacubitril and 26 mg of valsartan (24/26 mg). This is sometimes called 50 mg (the sum of both strengths).
- 49 mg of sacubitril and 51 mg of valsartan (49/51 mg). This is sometimes called 100 mg (the sum of both strengths).
- 97 mg of sacubitril and 103 mg of valsartan (97/103 mg). This is sometimes called 200 mg (the sum of both strengths).
Entresto Sprinkle comes in two strengths:
- 6 mg of sacubitril and 6 mg of valsartan (6/6 mg). This is sometimes called 12 mg (the sum of both strengths).
- 15 mg of sacubitril and 16 mg of valsartan (15/16 mg). This is sometimes called 31 mg (the sum of both strengths).
What are the usual dosages of Entresto in adults?
Your doctor will likely start you on a low dosage and adjust it over time to reach the right amount for you. They’ll ultimately prescribe the smallest dosage that provides the desired effect.
The information below describes dosages that are commonly used or recommended. But be sure to take the dosage your doctor prescribes for you. They’ll determine the best dosage to fit your needs. In some cases, doctors may adjust your dosage from those shown below.
Dosage for heart failure
Entresto is used in adults who have long-lasting heart failure to help reduce the risk of hospitalization and death.
The typical Entresto starting dosage is 49/51 mg twice daily. After 2 to 4 weeks, your doctor may increase the dosage to 97/103 mg twice daily.
The Entresto maximum dosage is 97/103 mg twice daily.
What’s the dosage of Entresto for children?
Entresto is used to treat heart failure that’s causing symptoms in children ages 1 to 17 years.
The dosage for children is based on their body weight in kilograms (kg). For reference, 1 kg is about 2.2 pounds (lb).
Entresto tablet
The dosing chart below explains the dosage for children taking Entresto oral tablet. Some doses below require multiple tablets. Children weighing 40 kg (88 lb) or more can take the oral tablet.
| Weight in kg | Approximate weight in lb | Starting dose | Second dose (2 weeks after starting dose) | Final maintenance dose (2 weeks after second dose) |
|---|---|---|---|---|
| less than 40 kg | less than 88 lb | • Doctor will prescribe Entresto Sprinkle (see table below). Or, • Pharmacist will make a liquid from the tablets and explain dosage. | • Doctor will prescribe Entresto Sprinkle (see table below). Or, • Pharmacist will make a liquid from the tablets and explain dosage. | • Doctor will prescribe Entresto Sprinkle (see table below). Or, • Pharmacist will make a liquid from the tablets and explain dosage. |
| 40 to less than 50 kg | 88 to less than 110 lb | 24/26 mg twice daily | 49/51 mg twice daily | 72/78 mg twice daily |
| 50 kg or more | 110 lb or more | 49/51 mg twice daily | 72/78 mg twice daily | 97/103 mg twice daily |
Entresto Sprinkle capsule
The dosing chart below explains the dosage for children taking Entresto Sprinkle. Some doses below require multiple capsules. Children weighing 13 kg (28 lb) to less than 50 kg (110 lb) can take Entresto Sprinkle.
| Weight in kg | Approximate weight in lb | Starting dose | Second dose (2 weeks after starting dose) | Final maintenance dose (2 weeks after second dose) |
|---|---|---|---|---|
| less than 13 kg | less than 28 lb | Pharmacist will make a liquid from the tablets and explain dosage. | Pharmacist will make a liquid from the tablets and explain dosage. | Pharmacist will make a liquid from the tablets and explain dosage. |
| 13 to less than 19 kg | 28 to less than 41 lb | 12/12 mg twice daily | 18/18 mg twice daily | 24/24 mg twice daily |
| 19 to less than 26 kg | 41 to less than 57 lb | 18/18 mg twice daily | 24/24 mg twice daily | 30/32 mg twice daily |
| 26 to less than 34 kg | 57 lb to less than 74 lb | 24/24 mg twice daily | 30/32 mg twice daily | 45/48 mg twice daily |
| 34 to less than 50 kg | 74 lb to less than 110 lb | 30/32 mg twice daily | 45/48 mg twice daily | 60/64 mg twice daily |
| 50 kg or more | 110 lb or more | Doctor will prescribe Entresto tablet (see table above). | Doctor will prescribe Entresto tablet (see table above). | Doctor will prescribe Entresto tablet (see table above). |
For more information about Entresto’s dosage for children, talk with your child’s doctor or a pharmacist.
Is Entresto taken long term?
Yes, Entresto is usually taken as a long-term treatment. You and your doctor can discuss whether it’s safe and effective for your condition. If you agree that it is, you’ll likely take it long term.
Frequently asked questions
Below are answers to some commonly asked questions about Entresto’s dosage.
What is Entresto 24/26 mg taken for?
The Entresto strength of 24/26 mg is prescribed for the smallest dose in the oral tablet form. Doctors may prescribe it for children who are able to swallow tablets and who weigh at least 40 kg (88 lb).
For adults, this dose also may be prescribed as a starting dosage if they haven’t taken similar drugs in the past.
Doctors also may prescribe this strength for adults who have liver problems or kidney problems.
Talk with your doctor or pharmacist if you have questions about your Entresto strength or dose.
Can Entresto tablet be cut in half?
The drugmaker has not recommended cutting the Entresto tablet in half.
If you have difficulty swallowing tablets, talk with your doctor or pharmacist. Your pharmacist may be able to make the tablets into a liquid for you to take. Or your doctor may prescribe Entresto Sprinkle instead.
How to take Entresto
Your doctor or child’s doctor may prescribe Entresto or Entresto Sprinkle. This section discusses how to take both forms.
Entresto tablet
You take Entresto tablet by swallowing it. You can take it with or without food. The drugmaker has not recommended cutting the Entresto tablet in half.
If you have difficulty swallowing tablets, your pharmacist can make a liquid from the tablets. Or your doctor may prescribe Entresto Sprinkle instead.
Entresto Sprinkle capsule
To take Entresto Sprinkle, open the capsule and sprinkle its contents onto a small amount of soft food. Examples of foods are yogurt, pudding, and applesauce. Be sure to eat the food right away. Do not chew or crush the pellets.
You should not swallow Entresto Sprinkle capsules whole. And do not swallow the empty capsules.
What should be done in case of overdose?
Do not take more Entresto than your doctor prescribes, as this can lead to harmful effects.
What to do in case you take too much Entresto
Call your doctor right away if you think you’ve taken too much Entresto. You can also call 800-222-1222 to reach America’s Poison Centers or use its online resource. But if you have severe symptoms, immediately call 911 or your local emergency number. Or go to the nearest emergency room.
Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
What is the typical dosage of Entresto?
Entresto is usually prescribed in a starting dose of 49 mg sacubitril/51 mg valsartan, taken twice a day. Depending on how well your body responds and tolerates the medication, your doctor might adjust the dosage after a couple of weeks.
What forms and strengths does Entresto come in?
Entresto is available in tablet form and comes in three strengths: 24 mg sacubitril/26 mg valsartan, 49 mg sacubitril/51 mg valsartan, and 97 mg sacubitril/103 mg valsartan.
### How should Entresto be taken?
Entresto should be taken exactly as prescribed by your healthcare provider. It is typically taken twice daily, with or without food. Make sure to swallow the tablet whole with water.
Can Entresto be taken with other heart medications?
Yes, Entresto may be prescribed alongside other heart medications. However, it should not be taken with other medications that contain ACE inhibitors or ARBs. Always inform your doctor about all the medications you are currently taking.
What should you do if you miss a dose of Entresto?
If you miss a dose of Entresto, take it as soon as you remember, unless it’s almost time for your next dose. In that case, skip the missed dose and resume your usual dosing schedule. Do not take extra doses to make up for a missed one.
Are there any special considerations for using Entresto?
Before starting Entresto, inform your healthcare provider if you have kidney or liver problems, are pregnant or breastfeeding, or have a history of angioedema. Your doctor will provide specific advice based on your health conditions.
Can lifestyle changes impact the effectiveness of Entresto?
Yes, lifestyle changes such as a balanced diet, regular exercise, and avoiding smoking can improve heart health and enhance the effectiveness of Entresto. Always follow your healthcare provider’s advice regarding lifestyle modifications.
