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British Heart Foundation
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Entresto Anyone els on this new drug?

Hi everyone I’m a new member and this is my very first post so please forgive me if I’m rambling as not sure Where to begin. Well here goes I had a heart attack and had to have 2 stents back in January 2015. I’ve had lots of tests over the years since and was put on the usual cocktail of meds tempered to suit me. but I was recently changed from one of them Losartan to a new drug called Entresto but unfortunately this drug didn’t seem to agree with me. I became more breathless and lightheaded anyway after reaching 50mg (mid dose) my heart failure nurse had to recommend that due to symptoms I revert back to Losartan 50mg. Anyway I’m still after couple weeks back on Losartan occasionally feeling light headed. My blood pressure has always been on low side so am only able to manage low dose 1.25mg bisoprolol taken at night before bedtime. I’ve been on that dose for long time without feeling lightheaded as often as I do now. The lightheaded feeling makes me feel anxious and I guess that magnifies the situation. Is there anyone els out there on or been on Entresto? Anyone els feeling lightheaded occasionally? If so do you know the cause? I’m just praying it’s not my heart getting weaker or am I letting anxiety get the best of me? Thanks for reading this post any replies would be greatly appreciated.

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Just wanted to welcome you. I'm sorry but I can't give you any advice about your new medication. No doubt someo

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On here will be able to help you. X Rie

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Hi Graham,

not on the new drug, but a cocktail of a few and yes occasionally light headed. I put it down to getting up to fast, or something similar, a few deep breaths and I get my equilibrium back but I do agree it can be a little unsettling at times

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Hi, thanks for your reply. The lightheaded feeling just seems to happen randomly not just when getting up to quickly, it Just seems worse lately and wondering if it’s anything to do with having short time on Entresto? Then reverting back to Losartan. It’s hopefully down to medication as most heart meds seem to have *lightheaded* as a common side affect. According to tests My heart function is apparently stable at around 38% I’m having regular blood tests (monthly) and as I don’t hear anything back from BHF heart nurse I guess all’s well. One other thing I’m not drinking 2ltrs water daily as I was told to but I drink diluted orange juice instead. Could this be a reason for feeling occasionally lightheaded? I Guess lots if not all heart patients are told to drink plenty of water with their meds. Looking forward to reading other members reply’s as to the lightheaded feeling and how to deal with it.

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More water might help. I have lots of heart issues, and If I feel lightheaded in exercise class I’m told to drink immediately. It works!

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Hi. I have been taking Entresto since the start of the year. Now I get on fine with it, no issues at all, but I was incredibly dizzy for the first few weeks. My other meds do make me light-headed, I think it's just a consequence of the low blood pressure that they're designed to cause.

I would check with your nurse/GP/consultant about the fluid intake. Most patients with hearts functioning below normal levels are advised to drink no more than 1.5 litres a day. Could they have meant 2 litres as a maximum rather than a minimum?

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Hi Laura, thanks so much for reply. When I was put on Entresto instead of Losartan I had high hopes of feeling better so am disappointed to be back on Losartan. My blood pressure didn’t really change much on Entresto so I did persevere but after 6 to 8 weeks I felt more breathless and lightheaded generally more unwell than I remembered feeling on Losartan. The heart nurses are unable to get me onto higher doses of meds like bisoprolol due to blood pressure problems but funnily enough my lightheadedness seems to be unrelated to blood pressure. The cardiologist said my heart is weak due to damage caused by me not seeking help and my heart not getting enough oxygen for over 10hrs but I wasn’t in great pain just thought it was indigestion. Anyway she said tests results show I don’t need defibrillator fitting at present time but I guess it’s something she feels I may need at later date. Just don’t like feeling lightheaded it’s especially worse at night.

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I don’t know whether this will help: there was an item on our TV news re Entresto. This patient had heart failure, was a farmer and could not do his work due to breathlessness. He managed to get the authorities to pay for the Entresto and was a different person ever since, doing his farm work, no breathing problems etc. I believe it is a very expensive drug.

Good luck!

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Hi Patches, thanks for commenting. Perhaps I should of stayed on Entresto it’s supposed to make a positive difference, I read that it’s supposed to be a wonder drug keeps you out of A&E Anyone els taking Entresto having positive or negative effects would like to comment?

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I have had more energy this year, for sure. I'm also being given iron as part of a medical trial, which might be a factor, but I do feel like Entresto has made more of a difference than any of the drugs I was on previously.

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I spoke to a Cardiologist on Tuesday about being light headed and the reply was " I am not really surprised the cocktail of medication you are on ". I take Eplerenone down from 50mg to 25mg with no change and also my Candesartan was reduced from 8mg to 6mg, Bisoprolol is at 5 mg and Isosorbide is at 60mg, Furosemide I titrate up and down depending on fluid level (Heart Nurse advice ) I can wake at night light headed but mostly it's if I have been bending down and then stand up. One side effect which I don't like is sometimes when walking I feel I am going sideways only for a moment or to but odd sensation. Just put these reactions down to show that other people have odd feelings when on various Heart Meds.

my BP is107/63 with a pulse of 40/55

Best Regards

Frank W

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Thanks for your reply Frank. Sounds like you’re having same reactions to meds as myself. Most interesting to hear other people’s experiences. I spoke with heart nurse yesterday and she said I need to have a blood test due to changing back to Losartan after a brief spell on Entresto check kidney function I guess. So will do that today. Best regards to you.

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Hi I was diagnosed with heart failure, dilated cardiomyopathy in Feb, I started on ramipril then moved on to candesartan and now on entresto, which I have been taking for about 6 weeks, 24/26 twice a day, along with two ferusomide, one spirolactane and 2.5 bisoprolol! Unfortunately none of them have made me feel any better my blood pressure is only 80/60 not great at all lol, I feel sick and dizzy quite a lot and sometimes, a not kind of there feeling, it's horrible, but I don't find it any worse than my previous meds so I am going to stick with the entresto and hope it will help the old ticker,with heart failure as Laura said fluid intake is usually restricted to 2 litres max, which to be honest I find it difficult as I always seem to be thirsty, it all makes you so fed up, I am also waiting for an appointment to get a defibrillator implant, my bloods have all been fine with entresto, take care and I hope you get the meds sorted, char xx

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Thanks for your reply Char. You have even lower blood pressure than me! Mine seems to be around mid 90s The other week I had a blood test and almost blacked out When the nurse took my blood pressure it had dropped to 82 must of been the shock of giving blood! Usually though low blood pressure doesn’t seem to bother me. I seemed ok on the low dose Entresto that your on but after they moved me up to mid dose I started to feel more unwell lightheaded etc. Now I’m back on 25mg Losartan I seem to feel better but still getting bouts of lightheadedness, especially at night. I’ve been told like everyone on here I guess that the heart can’t repair itself so the damage is permanent and I will need to take meds for rest of my life, but so many can’t be good for your kidneys? I suppose that’s why you need to drink plenty of water. I will have faith in the experts though and take any pill they tell me to but will I ever get to feel “normal” again? I thought having stents put in would make things better but in my case it hasn’t. Must be the damage, my heart damage is classed as severe. Still could really do without the lightheaded feeling as if you’re about to faint, it’s making me more anxious which just makes it even worse. All the best with your defibrillator I’ve heard it’s a simple procedure nothing to worry about, consultant said I will need one to but luckily not just yet. Regards Graham

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Hi it is a pain I wish I could do something to make it higher, the opposite of most folk! I worry when I am driving all the time, I try not to venture far now, my heart nurse would like my dosage increased to try and get heart rate down from 68 to 60 but the blood pressure is a big prob, she is going to check with the cardiologist to see if he can come up with something, will keep you posted, char x

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Hi Char, it’s same for me over the 2 years I’ve been on meds the heart nurse has tried to get dosage up but it never seems to be long before they tell me to go back on lower dose. Hopefully though in time I’ll be on required dosage. Best wishes

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Hi there. I take the full dose of Entresto twice a day. From being a non smoking, vegetarian and not an ounce overweight, I was diagnosed with Dilated Cardiomyopathy recently. Apparently I was in danger of cardiac arrest any minute - according to my specialist.

However, Entresto seems to be agreeing with me so far. I say this as things can so often change. I do get a little light headed occasionally as I have low blood pressure but generally it seems to be doing the trick. The lightheadness will be caused by your low blood pressure. Do tell your Heart Failure nurse as important.

I understand completely your anxiety but I tend to overfill my time so I don't have time to think. Initially I could not believe my diagnosis but now I'm determined to live every minute to the "nth" degree.

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Just came across this post and have now joined. My husband has severe heart failure after a CA followed by 5 x bypass and new mitral valve 5 years ago. He has been on Entresto for over a year as his options had run out really. He did feel more dizzy than usual when he started taking Entresto. But he was advised by his BHF nurse that he should persevere. As with all meds its about balance. It took approximately 6 months to get it right but it has decreased the number of clinic visits and he takes less meds including less furosemide. His BP used to be on the high side and it is now 120/80. How brilliant is that for someone with less than 35% EF? Its perseverance and balance BUT Entresto probably doesn't suit everyone. Hope that helps someone.

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My hubby was on Entresto. The doc miss prescribed the dosage and but him on the maximum strength! It needs to be slowly and gradually introduced to your body. It was a nightmare. He slept for 20 hours for a week. Our GP took him off and then he had AFib. Cardio doc says that AFib wasn’t caused by Entresto...I have my doubts. In any case the med wasn’t meant to be for him. It’s a new drug that just got approved here in the States. Just be sure to have your doc watch your kidney function. It can be a pretty nasty drug on that front. I did a lot of investigating into Entresto. The heart docs think it’s great but the long term affects on the body are still unknown. It’s also a pricey drug $500 for a month supply. Seems to be better for folks under 60 but here in US the TV ads show it with us seniors walking breathlessly before then doing cartwheels and hand flips with the grandkids after taking Entresto. God Speed with your recovery.

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