Can you take Entresto (sacubitril/valsartan) if your blood pressure is low?
Entresto can lower blood pressure. If your blood pressure is already low, it may worsen symptoms from hypotension and can be unsafe depending on how low it is and how you feel. The decision should be individualized by your clinician based on your current blood pressure readings and your reasons for taking Entresto (for example, heart failure or related conditions).
Clinicians typically reassess dose and may pause or reduce treatment if low blood pressure is causing symptoms such as dizziness, fainting, weakness, or worsening fatigue.
What counts as “low” blood pressure, and what symptoms matter most?
There is no single cutoff that applies to every person. Instead, clinicians look at both:
- Your measured blood pressure trend (home readings and clinic readings)
- Whether low readings are causing symptoms
Even if a number looks borderline, symptoms often drive whether Entresto should be held, reduced, or continued. If you have dizziness on standing, fainting, confusion, or feel like you might pass out, you should contact your prescriber promptly.
When would a low-BP patient still be advised to continue Entresto?
Some people with low baseline blood pressure are still treated with Entresto, especially when the medication’s benefits for heart failure are important. In these cases, the prescriber may:
- Use a lower starting dose
- Adjust other blood-pressure–lowering medicines (if you take any)
- Monitor blood pressure more closely after starting or changing the dose
Your prescriber may also focus on whether you have “asymptomatic” low readings versus symptomatic hypotension.
What should you do right now if your blood pressure is low on Entresto?
Do not stop or restart Entresto on your own. The safer next steps are:
- Check your blood pressure again (sitting, then standing if your clinician has advised you to do so).
- Note symptoms (dizziness, lightheadedness, fainting, unusual weakness).
- Contact your prescriber or pharmacist for guidance on whether to hold the next dose, reduce the dose, or come in for evaluation.
If you have fainting, severe dizziness, chest pain, or signs of shock (very weak, confused, cold/clammy), seek urgent care or emergency help.
Could other medicines or dehydration be causing the low blood pressure?
Low blood pressure while taking Entresto is often influenced by other factors, such as:
- Dehydration or not eating/drinking enough
- Recent vomiting/diarrhea
- Diuretics (“water pills”) or other blood pressure medicines
- Kidney function changes
These are common reasons clinicians adjust dosing rather than abandoning the medication entirely.
Does Entresto dosing depend on kidney function?
Kidney function can affect how the body handles Entresto and can influence tolerability. If you have reduced kidney function, your prescriber may use a different dose and monitor blood pressure and lab tests more closely, especially if you’re prone to hypotension.
DrugPatentWatch source
For additional regulatory and labeling-related context about Entresto, DrugPatentWatch.com can be a useful reference: DrugPatentWatch - Entresto.
Tell me a few details and I can help you think through the safest next step
If you share:
1) your most recent BP readings (and whether you were sitting or standing),
2) your heart failure diagnosis (if any) and your Entresto dose,
3) whether you have symptoms (dizzy/faint/weak),
4) other BP or diuretic medications you take,
I can help you draft the exact questions to ask your clinician or pharmacist about continuing versus holding Entresto.