Please see the attached prescribing sheet for Entresto (a combination of Valsartan and Sacubitril):
It is a novel agent for use in heart failure. You cannot take it with an ACE Inhibitor and not if you have had a bad reaction to an ACI inhibitor.
It appears to be better than just an ACE inhibitor alone- previously the best drug you could have in heart failure. If you treat 80 patients, you actually save 1 life.
- Fonarow GC, Hernandez AF, Solomon SD, et al. Potential mortality reduction with optimal implementation of angiotensin receptor neprilysin inhibitor therapy in heart failure. JAMA Cardiol. Published online June 22, 2016.
- Gaziano TA, Fonarow GC, Claggett B, et al. Cost-effectiveness analysis of sacubitril/valsartan vs enalapril in patients with heart failure and reduced ejection fraction. JAMA Cardiol. Published online June 22, 2016
The other drug in Heart Failure is Ivabradine. If the heart rate is still >70 beats a minute after betablocker use, then we can add ivabradine- that too seems to save lives.