As a heart failure treatment drug, Entresto's side effects involve multiple systemic reactions and require effective management through monitoring and targeted measures to balance efficacy and safety.

1. Common side effects and alleviation

(1) Hypotension

Manifesting as dizziness or fatigue, it is recommended to monitor blood pressure for 4 hours after the first administration to avoid getting up quickly. In severe cases, the dosage of diuretics should be adjusted or taken in divided doses.

(2) Hyperkalemia

Regularly monitor blood potassium levels and limit intake of high potassium foods. When combined with potassium sparing diuretics, more frequent monitoring is required, and potassium reducing resins should be used if necessary.

(3) Deterioration of renal function

Elevated creatinine may occur during the initial stage of medication. It is recommended to assess renal function at baseline and avoid use in patients with severe renal insufficiency. Adjust the dosage or suspend administration when abnormalities occur.

2. Side effects that require urgent handling

(1) Angioedema

Manifested as facial/throat swelling, immediate discontinuation of medication and administration of antihistamines or adrenaline is required. Individuals with a history of vascular edema should not use this medication.

(2) Severe allergic reaction

When a rash accompanied by fever or difficulty breathing occurs, the medication should be permanently discontinued, and anti allergic treatment should be performed if necessary. The presence of valsartan components may induce such reactions.

3. Long term medication precautions

(1) Liver function monitoring

Check liver function every 3-6 months, and discontinue medication if jaundice or ALT levels increase more than threefold. Patients with active liver disease are prohibited from using it.

(2) Prevention and control of pregnancy risks

Women of childbearing age should take reliable contraceptive measures when taking medication, and stop taking medication immediately if pregnancy is detected. Medications may cause fetal damage or even death.

4. Drug interaction management

(1) RAAS inhibitor

Do not use it in combination with ACEI, and there should be a 36 hour interval between switching treatments. Combined use with ARB increases the risk of hypotension/renal dysfunction.

(2) NSAIDs drugs

The combination may weaken the antihypertensive effect and increase blood potassium, and monitoring needs to be strengthened. Suggest prioritizing the use of acetaminophen as a substitute.