Contraindications and Precautions for Entresto Administration

Absolute Contraindications

• Patients with a history of angioedema related to previous ACE inhibitor or ARB therapy should not receive Entresto due to increased risk of recurrent angioedema, as recommended by the American College of Cardiology 1
• Do not administer Entresto within 36 hours of switching from or to an ACE inhibitor due to increased risk of angioedema, according to the American College of Cardiology 1

Cautions and Relative Contraindications

• Use Entresto with caution in patients with systolic blood pressure <100 mmHg or in volume-depleted patients, as cautioned by the American College of Cardiology and the European Heart Society 2, 3
• Dose adjustment is required for severe renal impairment (eGFR <30 mL/min/1.73m²), as recommended by the American College of Cardiology 2

Special Populations Requiring Caution

• No specific contraindication exists for elderly patients, but monitor for hypotension and renal function changes, as advised by the European Heart Society 3

Monitoring Recommendations When Using Entresto

• Monitor blood pressure regularly, especially when initiating therapy or increasing doses, as recommended by the European Heart Society 3

Clinical Pearls

• When switching from an ACE inhibitor to Entresto, a washout period of at least 36 hours is mandatory to reduce angioedema risk, as recommended by the American College of Cardiology 1, 2
• ARBs may be used as alternatives to ACE inhibitors and Entresto in patients with a history of angioedema, according to the American College of Cardiology 1