From Losartan to Entresto

[HenryTudor]

Following up on my MRI scan a month and a half ago I attended the Heart Failure nurse this morning. It was a good and helpful session. The MRI indicated a reduced heart function since my HA in February 2020. Since the scan I’d descended into the “worried well” hole, but mostly because I had the dreaded c in the summer and I’m not quite over the ‘flu I picked up in between Christmas and NY.

I’ve been taken off Losartan and put on Entresto. My Atorvastatin dose has been halved. The purpose is to improve my breathing. Overnight my blood oxygen level is low, but it’s okay during the day. I’m just interested to know if anyone has made this change, and any problems. I only rarely suffer from side effects.

Thanks.

[RufusScamp]

I was switched from Ramipril to Entresto about 2 years ago, and my heart function has greatly improved. If you can tolerate it, it seems to be a bit of a wonder drug in many cases.

I have had no noticeable side-effects.

[HenryTudor in reply to RufusScamp]

Thanks for that. I change tomorrow morning and wiil let you know how I get on.

[irishwife93]

My husband has recently changed from Ramipril to Entresto and feels a million times better, no side effects so far and he’s been going up and up through the doses. Ramipril was ruining his taste buds and that seems to have reversed with Entresto. Low blood pressure may be something you need to watch out for with Entresto, take it easy when sitting up and down for the first few days while your body adjusts! Hopefully they’ll titre your dosage so you start on the lowest and gradually move up, that way side effects are less likely

[Frogpond]

Iv'e been taking Entresto since October last year and it has made me feel so much better that I have ,I can move faster and walk quicker instead of feeling I was wobbling around like a drunk,(and I don't drink alcohol at all).BP did play up for a couple of days got a trifle low but all good now steady on 118/65. No other side effects it seems to be a very tolubul drug .Good luck with it I'm sure you will be pleased with the outcome. Cheers.

[Molben]

Hi, I went from Losartin to Entresto. I was put on to a high dose to start and had problems with my blood pressure dropping too low. I had to stop taking it for a short while to get my blood pressure back up then I restarted it on a lower dose and I am fine. Its a good drug and seems to be the go to drug now. I am grateful that it is around. Physically I am doing better now. I started it about October. All I would say, when you start taking it be aware when standing up too fast or moving your head around that you may feel slightly dizzy. It will pass, its just the readjustment. Stick with it. Good luck.

[Familyk]

Hi,I will be switching from losartan to entresto next week so I was interested to read your replies. I'm starting on the lower dose 24/26 and hoping to build up to highest I can tolerate. My ef is currently 32 so cardiologist wants higher dose.

I'm going to be watching for your progress if that's OK?

Really hope it works for you and start to reap the benefits

L x

[HenryTudor in reply to Familyk]

Yes, I’m very happy to share my experience and you’ve answered my question in that 24/26 mgs is a low dose.

It’s two hours since my first dose and BP is pretty much the same as it always is. I don’t obsess over my BP and only measure every one or two weeks, but might go for every day during this period.

[Familyk in reply to HenryTudor]

My cardiologist said there are actually 4 levels of Entresto. 24/26 being the lowest. Research has shown that the results are better the higher the dose apparently. Mine is being increased in 6 weeks after an mri and echocardiogram and 2 day heart monitor. I hope I'm as lucky as you are at the moment as I start a new job at the same time as starting entresto, timing not the best bit unfortunately can't be helped.

X

[HenryTudor in reply to Familyk]

Thanks for the further info. You starting a new job has got me thinking. Does that make it more difficult or easier?

With too much time on our hands it’s easy to over think things. After coming out of hospital I was very narrowly focused on losing weight and getting fit. Then this last summer I got the dreaded ‘C19’. It was dire and, not working, I lost focus and lost my way. I love walking and hiking but we’re advised not to be outdoors when it’s this cold.

Over the years I had only one or two bouts of minor ill health but focusing on the need to be healthy to do the best job I could was beneficial. Good luck in your new job - new people, new things.

Hx

[HenryTudor]

Thank you for the replies, which are very encouraging. I’m on 24/26 mg twice a day. The HF Nurse was good at explaining in the broad sense why my medication is being tweaked. But she said nothing about whether this dose is low, and will be increased, or whether it’s high and might be reduced.

I’m going back in two weeks for review which is reassuring.

Something I’ll reluctantly mention is that the nurse seemed affronted when I said I use my Apple Watch and a Withings scale/scanner to monitor my body metrics and stay as well as I can. She actually drew a circle around her face with her finger and said, “You can see my sceptical face.” Ho hum.

[Prada47]

Hello 24/26 is the lowest dose next one up is 49/51 can't remember as I have thrown the data sheet out. but the next dose is 98/102 more or less just doubling up !!

I am on 49/51 Entresto twice a day, the next med was/is forxiga ( dapagliflozin )

My BP is a little low well normally around lower to upper 90s over 60 just took it now and it's 140/73 with a Heart Rate of 52 so it can be quite variable !! My ef was 44% when I started on Entresto it has gone down slightly to 38%,but my symptoms have improved I breathe easier which is a bonus.. When I questioned my HF nurse about the drop in ef she just said think where it might have been if you wasn't on Entresto.

Haven't had any side effects only BP variable but we are all different with different Heart problems I think I am saying sometimes one size doesn't fit all.

What other meds are you on ? it's just interesting to know.

Regards

[HenryTudor in reply to Prada47]

Thanks for your comments.

I’m also on:

Ticagrelor, Bisoprolol, Atorvastatin & Asprin

[irishwife93 in reply to Prada47]

I have been told by a consultant that it’s normal for EF to fluctuate a few percentages due to differences with how it’s calculated, who does the scanning, even differences in machinery. So the slight drop may just be because someone else did your scan the last time or they recalibrated whichever machine they used!

[Prada47 in reply to irishwife93]

Hi just to say I was using MRI figures which my Consultant said are a lot more accurate than an Echocardiogram !!

I do have a complex Cardiac Anatomy ( consultants description ) hence my comment we are all different. My ef was/is decent at 38% just symptoms on NYHA scale can be off the scale. I have been told I am at the end of the line for medication so hey ho, and my Cardiologist has also said he has done everything he can with interventions so I just have to soldier on LOL

I am very fortunate I don't have any anxiety issues I think I just take everything in my stride, I kind of don't worry over what I can't influence.

I believe a major point with Heart Failure that we all have to accept is it will probably get worse the older we get, until a cure is found

regards

[Ang5b]

Hi Henry, I now take maximum dose of Entresto instead of Lorsartan. It’s a new wonder drug. I’m lucky I can tolerate higher dose. My EF has been raised to 41. Cardiologists say evidence for Entresto is overwhelming that it can prolong life for heart failure patients. Heart failure being an umberella term. I’m sure you will see improvement with it. Take care

[HenryTudor in reply to Ang5b]

Thanks for that.