Entresto and Blood pressure .

[bones-bones]

Hello. I need some help please !

I have Left vetricular dysfunction plus left bundle block……resulting in heart failure. Low EF.

I have been taking Ramapril and Carvedilol and recently Dapagliflozin. Four weeks ago the Ramipril was replaced with Entresto (lowest dose) Since then my bp has dropped intermittently…usually going up after drinking lots of water. On Tuesday it was 124/66 dropping later to83/52. Today it is 104/53.

My bp has never been stupidly high previous to Chemo which seems to have caused the heart failure.

I hope I have put that clearly !…..I’m flapping a bit.

The plan is to slowly up the dose to the next stage.

What would you do if you were me ? Entresto is apparently the dream answer to HF.

[RufusScamp]

Entresto certainly worked for me. E/F 20% up to 60%. If you can tolerate it, it's worth persevering with. But discuss it with you cardiologist. All our cases are different.

[MyHF]

hi there. I’m not medically trained but your blood pressure readings seem extremely low! I’m on middle dose and bp sits around 106/62 so I was never put up to top dose. I seem to remember when I was in hospital some1 had said if the second number drops below 60 then they would be concerned. Definitely worth keeping an eye on it and maybe talking to gp at least if it stays that low?

[Jackabee]

I can only say that on Entresto, my EF went from 30 to 60. It wasn’t easy and I felt dizzy and sick on each increase in dose…I even threw up in restaurant full of people which was, of course, mortifying. However, it was well worth persevering in my case.

[Larneybuds]

Hi....I am on the lowest dose and though my BP took a while to stabilise, it's now fairly steady. If in doubt I think a chat to your doctor would be beneficial. Are you still asking any other meds that could be affecting the way the enteresto is working. Only asking as I always read everything about any meds I have been given and I was recently prescribed an antibiotic that clashed with one of my heart meds. I queried it with the doctor who double checked with my heart consultant....so glad I did as it put my mind at ease and also the doctor said it was good that I queried it. I hope you don't have too many problems and how you get sorted. All the best x

[Snackjack]

I was on Ramipril which was changed to Entresto 24 mg twice a day and I kept feeling like I was going to pass out in a morning, I was told to just take the one at night time and since I stopped taking the one in a morning it has been fine. Obviously follow the advice of your Cardiologist as we are all different.

[Pouchielou1972]

I also went from Rampiril to Entresto. I'm on the highest dose and I went through dizziness, fatigue and the infamous 'Entresto cough' side effect and very low blood pressure 80/50...but stuck with it and have thankfully come out the other side and my ED has gone from 10% to 53%.

[bones-bones]

Thank you all for your help. It’s good to hear everyone else’s stories.Incidentally I forgot to admit I am 80 !

I am going to drink a lot more (water !) and persevere. I think it has to be a gradual process. I am about to up my evening dose to the next step but not the morning dose yet.

You are lucky to have the ‘go and see your GP’ option. Waiting for a few weeks is more likely here. But we have very good HF nurses ready to give advice.

Good luck everyone.

[DiggyDoggy]

Hi,

I also went from Ramipril to Entresto. Sadly my EF did not increase from its previous 35%, despite many people gaining from Entresto in that regard.

My blood pressure is around 105/60 but apparently lower than usual blood pressure is OK so long as you don't feel faint - which I don't.

I hope that it all works out for you soon!

[bones-bones in reply to DiggyDoggy]

Thank you diggy doggy. Some we win some we lose ! I will continue with plan unless I faint .

[Penoir53]

Sending love. Just tootling through the posts and I found my 2nd ever person to have heart failure from bc chemo. Mine from chemo itself revealed by Herceptin. What a great club! I was on the baby dose of Entresto and they reduced my beta blocker to increase Entresto to normal starter. It has been tough. Grit your teeth. If the low bp is stopping you living well then increase not great idea. After a year even the baby dose gave me a slightly better echo result. It's a LOT to deal with isn't it as the Heart failure symptoms, drug side effects and 'things to watch out for after cancer' list are almost the same. So sending love and consult closely with Cardio. Big hugs xx

[bones-bones]

Hello Penoir How kind of you to write.

I think it was the Herceptin that did for me. I had to stop half way through the course as my EF was in trouble. I am taking Carvedilol and Dapagliflozin..neither has given me any trouble but then they swapped my Ramipril for Entresto ! I am now taking middle dose at night and low dose in the morning . Some days I feel better..and some days I don’t. I think I will ask the Nurse if I can reduce the Carvedilol. They keep telling me Entresto is a wonder drug and I want to tell them I’m only here in Cardiology because of the last wonder drug I was given but that might sound ungrateful .I suppose I’m lucky that they still think I’m worth saving aged 80 ! I guess you are a lot younger.

How is the NHS where you are ? I couldn’t contact Cardiology for 3 years during Covid but I assume we were all in the same boat.

Anyhow here we are. I am sitting here piling on the flab. They don’t mention it luckily for them . I’m also rather immobile as I also have an autoimmune condition …..or cancer is back. As you say it’s Hobson’s Choice !

I wish you all the luck in the world with all this rubbish….with love Liz