Entresto is a heart failure medication combining Sacubitril and Valsartan. Learn what it's used for, how to take it, dosage info, costs, and more in 2026.
Entresto is a prescription medication used to treat heart failure in adults and children aged 1 year and older, made by combining two active ingredients — Sacubitril and Valsartan — to reduce the risk of cardiovascular death and hospitalization.
If you or someone you care for has been prescribed Entresto, this guide covers everything you need to know: what it is, what it treats, how to take it, who shouldn't take it, and how much it costs in 2026.
Entresto is the brand name for the combination drug Sacubitril/Valsartan. It was developed by Novartis Pharmaceuticals and first approved by the FDA in July 2015. It belongs to a drug class called angiotensin receptor-neprilysin inhibitors, or ARNIs — a class that Entresto pioneered.
Here are the key details:
Entresto was a breakthrough because it was the first medication to combine an ARB (Valsartan) with a neprilysin inhibitor (Sacubitril) into a single pill. In the landmark PARADIGM-HF clinical trial, Entresto reduced the risk of cardiovascular death by 20% and heart failure hospitalization by 21% compared to Enalapril, a standard ACE inhibitor.
Entresto is FDA-approved for:
Heart failure means the heart isn't pumping blood as efficiently as it should. Ejection fraction (EF) measures how much blood the left ventricle pumps out with each beat. In HFrEF, the EF is typically 40% or lower. In HFpEF, the EF may be normal, but the heart is still not filling or relaxing properly.
Entresto is a cornerstone of what cardiologists call guideline-directed medical therapy (GDMT) for heart failure — meaning it's one of the first-line medications recommended by the American Heart Association and American College of Cardiology.
Entresto is an oral tablet taken twice daily — once in the morning and once in the evening. It can be taken with or without food.
Entresto comes in three tablet strengths:
Starting dose: Most patients start at 49/51 mg twice daily. A lower starting dose of 24/26 mg twice daily is used for patients who:
Target dose: 97/103 mg twice daily. Your doctor will increase the dose gradually — typically every 2 to 4 weeks — as your body tolerates it.
If you're switching from an ACE inhibitor (like Lisinopril, Enalapril, or Ramipril), you must wait at least 36 hours after your last ACE inhibitor dose before starting Entresto. This is critical to reduce the risk of angioedema (a dangerous swelling reaction).
Entresto is not safe for everyone. You should not take it if you:
Entresto is also not recommended for breastfeeding mothers due to potential risk to the infant.
For a full list of medications to avoid, see our guide on Entresto drug interactions.
Cost is one of the biggest concerns patients have about Entresto. Here's the current pricing landscape in 2026:
Without insurance, brand-name Entresto costs approximately $600–$700 per month for a 30-day supply (60 tablets at the maintenance dose).
Generic versions became available after Entresto's patent expired in July 2025. Generic Sacubitril/Valsartan costs approximately $45–$255 per month depending on the pharmacy and discount card used. With a GoodRx coupon, prices can be as low as $45.
Entresto was one of the first 10 drugs selected for Medicare price negotiation under the Inflation Reduction Act. The negotiated maximum fair price is approximately $295 per 30-day supply for Medicare beneficiaries, starting in January 2026.
The Novartis Entresto Co-Pay Card can reduce costs to as little as $10 per month for commercially insured patients, with annual savings up to $4,100. This is not available for government-insured patients (Medicare, Medicaid, Tricare).
For more ways to save, read our complete guide on Entresto coupons, discounts, and patient assistance programs.
Entresto is a proven, guideline-recommended medication that has changed heart failure treatment for millions of patients. It reduces hospitalizations, lowers the risk of cardiovascular death, and is now available in a more affordable generic form.
If you've been prescribed Entresto, the most important things to know are: take it twice daily as directed, don't skip doses, keep your follow-up appointments, and talk to your doctor about any side effects before stopping the medication.
Need help finding Entresto at a pharmacy near you? Medfinder can help you locate Entresto in stock and find the best price.
You focus on staying healthy. We'll handle the rest.
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