What is Entresto?
Entresto is a prescription medication used to treat adults and children over one year of age with long-lasting (chronic) heart failure. It is a combination of two active substances, sacubitril and valsartan, and it works by reducing the strain on the failing heart. Sacubitril is a neprilysin inhibitor that blocks the breakdown of beneficial peptides that help remove sodium and fluid, while valsartan is an angiotensin II receptor blocker (ARB) that helps relax blood vessels. Together, they improve the heart's ability to pump blood throughout the body, helping to reduce the risk of death and hospitalization related to heart failure.
The Link: Does Entresto Cause Diarrhea?
Yes, diarrhea is a known side effect of Entresto. It is listed as a common gut-related side effect alongside nausea and stomach pain. While the most prevalent side effects of Entresto are low blood pressure (hypotension), high potassium levels (hyperkalemia), and cough, diarrhea is a recognized adverse reaction.
Pharmacovigilance studies have investigated the link, suggesting that the sacubitril component may play a specific role in causing diarrhea. One study noted that with sacubitril/valsartan, diarrhea tended to occur with a median delay of 3 days after starting the medication or increasing the dose. It's also important to note that dehydration resulting from severe diarrhea or vomiting can increase the risk of other side effects like dizziness and low blood pressure.
How to Manage Diarrhea Caused by Entresto
If you experience diarrhea while taking Entresto, it is important to manage the symptoms to prevent dehydration and other complications. Severe or persistent diarrhea should always be discussed with a healthcare provider.
Key Management Strategies:
- Stay Hydrated: Drink plenty of clear liquids, such as water and broth, to replace lost fluids. Aim for adequate daily fluid intake unless on a fluid restriction. Dehydration can lead to low blood pressure, which is also a risk with Entresto.
- Dietary Adjustments: Follow the BRAT diet (bananas, rice, applesauce, toast), which consists of bland, low-fiber foods. Avoid spicy, greasy, or high-fiber foods, as well as caffeine and alcohol, which can irritate the bowels.
- Over-the-Counter (OTC) Medications: Before taking any anti-diarrheal medication like loperamide (Imodium), consult your doctor to ensure it's appropriate for your situation. Your doctor can provide guidance on appropriate use.
- Skin Care: Frequent bowel movements can cause skin irritation. Keep the anal area clean and dry, and consider using a barrier cream to protect the skin.
When to Contact a Doctor
It is essential to contact your doctor if you experience:
- Severe, persistent, or worsening diarrhea.
- Signs of dehydration, such as dizziness, light-headedness, fainting, or decreased urination.
- Symptoms of high potassium (hyperkalemia), such as muscle weakness, nausea, or an irregular heartbeat, which can also be accompanied by diarrhea.
- Fever or blood in your stool.
In some cases of persistent diarrhea, a doctor might consider a temporary dose adjustment of Entresto or evaluate for other potential causes.
Comparison of Common Entresto Side Effects
Diarrhea is one of several potential side effects. Here is how it compares to other common adverse reactions based on prescribing information and clinical data:
| Side Effect | Typical Prevalence | Key Characteristics |
|---|---|---|
| Hypotension (Low Blood Pressure) | Very Common (>10%) | Can cause dizziness, light-headedness, and fainting. More common when starting the medication or with dose increases. |
| Hyperkalemia (High Potassium) | Very Common (>10%) | Can be serious and may cause muscle weakness, fatigue, or changes in heart rhythm. Requires monitoring via blood tests. |
| Cough | Common (1-10%) | A persistent, dry cough can occur. |
| Dizziness | Common (≥5%) | Often related to the medication's effect on blood pressure. |
| Renal Impairment (Kidney Problems) | Very Common (>10%) | The medication can affect kidney function, which requires monitoring. |
| Diarrhea | Common | Gastrointestinal side effect that can lead to dehydration if not managed. |
Conclusion
While Entresto is a highly effective medication for managing heart failure, it does carry the potential for side effects. Diarrhea is a recognized common side effect, though often less frequent than issues like low blood pressure and high potassium levels. Patients should be aware of this possibility and know that management strategies focusing on hydration and diet can be effective. Always maintain open communication with your healthcare provider about any side effects you experience, as they can provide the best guidance for your specific situation, which may include dose adjustments or other interventions to ensure your treatment remains both safe and effective.
For more detailed information, you can review the official prescribing information from the FDA.
