As they may be at higher risk for angioedema, caution is recommended if Entresto is used in these patients.
Entresto is contraindicated in patients with a known history of angioedema related to previous ACE inhibitor or ARB therapy or with hereditary or idiopathic angioedema (see section 4.3).
There is limited experience in patients not currently taking an ACE inhibitor or an ARB or taking low doses of these medicinal products, therefore a starting dose of 24 mg/26 mg twice daily and slow dose titration (doubling every 3-4 weeks) are recommended in these patients (see “Titration” in section 5.1).
Treatment should not be initiated in patients with serum potassium level Elderly population The dose should be in line with the renal function of the elderly patient.
If patients experience clinically significant hyperkalaemia adjustment of concomitant medicinal products, or temporary down–titration or discontinuation is recommended.Patients with mild and moderate renal impairment are more at risk of developing hypotension (see section 4.2).There is very limited clinical experience in patients with severe renal impairment (estimated GFR Use of Entresto may be associated with decreased renal function.Hepatic impairment No dose adjustment is required when administering Entresto to patients with mild hepatic impairment (Child-Pugh A classification).There is limited clinical experience in patients with moderate hepatic impairment (Child-Pugh B classification) or with AST/ALT values more than twice the upper limit of the normal range.