What Is Entresto (Sacubitril/Valsartan)? Uses, Dosage, and What You Need to Know in 2026

Entresto (sacubitril/valsartan) is one of the most significant advances in heart failure treatment in decades. Since its FDA approval in July 2015, it has become a cornerstone of care for millions of patients with heart failure. Here is everything you need to know about this medication in 2026.

What Is Entresto?

Entresto is a prescription heart failure medication that combines two active ingredients: sacubitril (a neprilysin inhibitor) and valsartan (an angiotensin II receptor blocker, or ARB). It is the first and only FDA-approved medication in the class called angiotensin receptor-neprilysin inhibitors (ARNIs). Generic versions of sacubitril/valsartan are now available from multiple manufacturers following the patent expiration in July 2025.

Novartis Pharmaceuticals developed Entresto, which generated $7.8 billion in global sales in 2024, reflecting how widely it has been adopted as standard of care.

What Is Entresto Used For?

The FDA has approved Entresto for two primary indications:

Chronic heart failure with reduced ejection fraction (HFrEF) in adults: To reduce the risk of cardiovascular death and hospitalization for heart failure. This is the primary indication. Patients with a left ventricular ejection fraction (LVEF) below normal benefit most.

Symptomatic heart failure in pediatric patients aged 1 year and older: For children with systemic left ventricular systolic dysfunction, as established by the PANORAMA-HF clinical trial.

Entresto is used in place of — not in addition to — an ACE inhibitor or ARB. It is combined with other standard heart failure medications including beta-blockers, mineralocorticoid receptor antagonists (like spironolactone), and SGLT2 inhibitors (like dapagliflozin or empagliflozin) as part of the current quadruple therapy standard of care.

What Dosage Forms Does Entresto Come In?

Entresto is available in three tablet strengths:

24 mg sacubitril / 26 mg valsartan — starting dose for patients not currently taking ACE inhibitors or ARBs, or with low blood pressure

49 mg sacubitril / 51 mg valsartan — typical starting dose for patients switching from an ACE inhibitor or ARB

97 mg sacubitril / 103 mg valsartan — target maintenance dose

For pediatric patients, Entresto Sprinkle capsules (containing oral pellets that can be mixed with food) are available in 6/6 mg and 15/16 mg strengths. An oral suspension can also be prepared for smaller children.

How to Take Entresto

Entresto is taken twice daily, with or without food. Key instructions:

Take it at the same time each day (e.g., morning and evening)

Do NOT take Entresto within 36 hours of an ACE inhibitor (like lisinopril, enalapril) due to the risk of life-threatening angioedema

Doses are typically doubled every 2–4 weeks as tolerated, targeting 97/103 mg twice daily

Store at room temperature (68–77°F / 20–25°C), in a cool dry place, away from moisture

Do not stop taking Entresto without talking to your doctor — stopping abruptly can worsen heart failure

Who Should NOT Take Entresto?

Entresto is contraindicated in:

Pregnant women (boxed warning for fetal toxicity)

Patients with a history of angioedema from ACE inhibitors or ARBs

Patients currently taking an ACE inhibitor (must wait at least 36 hours after stopping)

Patients with diabetes taking aliskiren (Tekturna)

Patients with severe liver disease (Child-Pugh class C hepatic impairment)

Where to Get Entresto in 2026

Generic sacubitril/valsartan is now available from multiple manufacturers and should be broadly available at major pharmacies. If you're having trouble filling your prescription, medfinder can contact pharmacies near you to check who has it in stock. And if cost is the barrier, read our guide on how to save money on Entresto in 2026.