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The following safety and warning information is critical for anyone considering or currently taking this medication. Please review these details carefully and discuss any concerns with your healthcare provider.

• Pregnancy Risk: This medication can cause severe, potentially fatal harm to an unborn baby. It is crucial to avoid pregnancy while using this drug. Consult your doctor about effective birth control options. If you are pregnant, planning a pregnancy, or suspect you might be pregnant, inform your healthcare provider immediately.

• Angioedema and Allergic Reactions: Some individuals may experience angioedema, a rare but serious allergic reaction characterized by swelling in parts of the body such as the face, throat, tongue, and stomach. This can be life-threatening if it obstructs breathing. Certain individuals, particularly Black individuals, older adults, or females, may have a higher risk. Seek emergency medical help if you notice unusual swelling, stomach pain, or breathing difficulties. Discontinue the medication if this occurs.

• Infection Risk Due to Low White Blood Cell Count: A reduction in white blood cell count, increasing infection risk, may occur with this medication, especially in those with kidney issues or autoimmune conditions like lupus. This typically happens within three months of starting the treatment. Your healthcare provider may conduct regular blood tests to monitor your WBC count. Pause the medication if counts are low. Watch for symptoms of infection, such as fever or chills.

• Low Blood Pressure: This medication may cause a drop in blood pressure, resulting in dizziness, tiredness, or lightheadedness. This is more likely when starting the medication or adjusting the dosage. Maintain adequate hydration, and stand up slowly if you feel dizzy. Seek immediate medical attention if you experience a fall.

• Kidney Function: While generally beneficial for the kidneys, this medication can worsen existing kidney issues, especially in those with conditions like renal artery stenosis or severe heart failure. Regular lab tests may be necessary to monitor kidney health. Report any decrease in urination to your healthcare provider.

• High Potassium Levels: There is a risk of elevated potassium levels, which can be harmful. This risk is higher if you have diabetes, kidney problems, or are taking other drugs that increase potassium. Inform your healthcare provider about your medical history and all medications you are taking. Seek medical attention if you experience symptoms such as nausea, muscle weakness, or irregular heartbeats.

• Liver Issues: Rare liver problems have occurred with this medication. Periodic blood tests may be performed to check liver function. Contact your healthcare provider immediately if you notice symptoms such as fatigue, stomach pain, or yellowing of the skin.

• Contraindications: Do not use this medication if you have a history of angioedema with ACE inhibitors, are taking aliskiren (Tekturna) with diabetes, or have taken captopril within 36 hours of Entresto (sacubitril/valsartan). Consult your healthcare provider if any of these apply to you.

Common side effects:

• dizziness
• lightheadedness
• changes in taste

• dry cough

  Less common but important to monitor:

• skin rash
• itching
• flushing
• low blood pressure

• fast heartbeat

  Serious side effects:

• angioedema
• trouble breathing
• wheezing
• dangerously low blood pressure
• serious kidney problems
• high potassium levels
• severe allergic reaction
• serious liver problems

Interactions with high risk of serious adverse effects and should be avoided:

• Aliskiren
• Sacubitril
• Bee/wasp sting allergy desensitization injections

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Allopurinol
• Amiloride
• Everolimus
• Lithium
• Losartan
• Certain other ARBs (e.g., Valsartan)
• Sirolimus

Interactions with low risk that usually do not require a change in therapy:

• Aspirin
• Ibuprofen
• Naproxen
• Other NSAIDs