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Entresto vs. Lisinopril

Authored by The Rx Advocates, / Medically Reviewed by Dr. Conor Sheehy, PharmD, BCPS
Last Updated: March 18, 2022

Entresto and Lisinopril are prescription medications that are used to treat heart failure. These medications are two different classes of drugs and have distinct effects on the body.

 

What is Heart Failure?

The term ‘heart failure’ might confuse some people. Heart failure is not, in fact, a heart that has stopped beating, but it is a condition in which the heart muscle is not working as well as it should.

This means the cells of the body do not get the oxygen and nutrients carried by the blood that they would get when the heart works properly. The body tries to correct itself at first.

The heart muscle will stretch to contract stronger and pump more blood, leading to an enlarged heart. The body will increase the muscle mass of the heart or start pumping faster.

These attempts by the body to correct the problem will help for a little while. That is why many people do not realize there is a problem at first. Eventually, this compensation no longer works, and the heart can not keep up. That is when a person notices symptoms.

Symptoms of Heart Failure

Symptoms of heart failure include:

  • Fatigue and weakness
  • Reduced ability to exercise
  • Shortness of breath 
  • Rapid or irregular heartbeat
  • Swelling of the legs, ankles, and feet
  • Persistent cough or wheezing
  • Swelling in the abdomen
  • Difficulty concentrating or decreased alertness

 

Treating Heart Failure With Prescription Medications

Over 6 million adults in the United States deal with heart failure, a condition that can also cause damage to the kidneys and liver. It is important to take this illness seriously.

There is no cure for heart failure, but it can be treated with lifestyle changes and medication. Taking these steps helps patients to have a higher quality of life.

 

Lisinopril

Lisinopril is used to treat high blood pressure in adults and children who are aged six or older. Patients can use Lisinopril in combination with other medications to treat heart failure. When combined with diuretics, it can be beneficial in the treatment of heart failure.

Lisinopril is an ACE inhibitor. ACE stands for angiotensin-converting enzyme. ACE inhibitors work by lowering the amount of chemicals in the body that tighten blood vessels, making it easier for blood to flow and for the heart to work better.

Side Effects of Lisinopril

Many prescription medications have unintended effects on the body called side effects. Lisinopril has some minor side effects and some possibly serious side effects.

Minor side effects can include:

  • Cough
  • Excessive tiredness
  • Headache
  • Dizziness
  • Diarrhea
  • Nausea
  • Sneezing
  • Runny nose
  • Rash

Serious side effects of Lisinopril are not very common but still could happen. Serious side effects to watch out for include:

  • Hypotension (low blood pressure)
  • Acute kidney failure
  • Liver damage
  • Allergic reactions
  • Angioedema (severe sudden swelling under the skin)
  • Changes in potassium levels
  • Miscarriage or severe damage to an unborn child

 

Entresto

Entresto is a combination of two medications. It is not an ACE inhibitor but is an angiotensin receptor blocker and neprilysin inhibitor.

Entresto is sacubitril and valsartan in one prescription medication. These two active ingredients work in different ways.

Valsartan is an angiotensin receptor blocker. This class of drugs works by stopping the action of a hormone called angiotensin 2. The hormone attaches to a receptor to produce an effect on the body.

The effects of Angiotensin 2 on the body are:

  • Salt and water retention
  • Narrowing of blood vessels
  • Stimulates blood vessel and heart fibrosis
  • Promotes heart cell growth

Valsartan blocks angiotensin 2 from connecting to the receptor, reducing its effects on the body.

Sacubitril is a neprilysin inhibitor. Natriuretic peptides signal the body to remove sodium from the blood. Moving excess sodium out of the bloodstream helps lower blood pressure. Neprilysin is an enzyme that breaks down natriuretic peptides, stopping them from working.

Sacubitril is only available in Entresto. By combining valsartan and sacubitril, Entresto helps the heart pump blood through the body easier.

Side Effects of Entresto

Just like Lisinopril, there are some possible side effects when using Entresto for heart failure. Possible mild side effects include:

  • Cough
  • Dizziness
  • Angioedema

There is the possibility of more serious side effects while taking Entresto. These are not common, but anyone using this medication should be aware of them. Serious side effects can include:

  • Severe allergic reaction
  • Hypotension (low blood pressure)
  • Kidney failure
  • Hyperkalemia (high levels of potassium in the blood)
  • Fetal toxicity (harm to an unborn baby)

Both Entresto and lisinopril have warnings from the FDA that pregnant women should not use them. Both medications are harmful to the unborn baby. Women who become pregnant while on either of these medications should talk to their doctor right away.

 

Which is Better?

Every person has to make that decision with their doctor. Both medications have the possibility for uncommon yet serious side effects, although Entresto has fewer mild side effects.

Lisinopril needs to be combined with diuretics to be used for treating heart failure effectively. 

Other medical factors always need to be considered when choosing a medication. Both Entresto and Lisinopril can help heart failure, but they work differently in the body.

 

Getting Help With Medication Costs

Prescription medications are expensive. This is especially true for people who have little or no prescription drug coverage. The Rx Advocates can help.

The Rx Advocates connect people with the prescription patient assistance programs offered by pharmaceutical companies for brand-name medications. We do all of the paperwork to get people into the programs.

For those who qualify, The Rx Advocates charge only a low monthly fee per medication. If someone is only using Entresto, they will only pay $60 per month. That is a huge savings.

We can help with many other brand-name prescription medications. When someone needs more than one drug each month, the monthly fee only goes up to $10 per prescription. The fee caps off at $90 for four or more medications.

No one should have to choose whether or not to use life-changing medications based on cost. The Rx Advocates can save people hundreds of dollars on their prescriptions each month. Please contact us today to start saving money.

 

Sources:

Drugs.com. Lisinopril.
https://www.drugs.com/lisinopril.html 2021.

American Heart Association. What is Heart Failure?
https://www.heart.org/en/health-topics/heart-failure/what-is-heart-failure 2021.

Mayo Clinic.Heart Failure.
https://www.mayoclinic.org/diseases-conditions/heart-failure/symptoms-causes/syc-20373142 2021.

National Heart, Lung, and Blood Institute. Heart Failure.
https://www.nhlbi.nih.gov/health-topics/heart-failure 2021.

PubMed. Lisinopril: a review of its use in congestive heart failure.
https://pubmed.ncbi.nlm.nih.gov/10852646/ May 2000.

MedlinePlus. Lisinopril.
https://medlineplus.gov/druginfo/meds/a692051.html 2021.

Medical News Today. Lisinopril oral tablet.
https://www.medicalnewstoday.com/articles/drugs-lisinopril-oral-tablet#side-effects July 20, 2021.

Entresto. Entresto (sacubitril/valsartan) tablets.
https://www.entresto.com/how-entresto-works 2021.

Drugs.com. Entresto.
https://www.drugs.com/entresto.html November 2021.

Circulation. Angiotensin Receptor Blockers. https://www.ahajournals.org/doi/full/10.1161/01.CIR.0000072344.12827.13 June 24, 2003.

PubMed. Natriuretic peptides: their structure, receptors, physiologic functions and therapeutic applications.
https://pubmed.ncbi.nlm.nih.gov/19089336/ 2009.

Medical News Today. Entresto (sacubitril/valsartan).
https://www.medicalnewstoday.com/articles/327055#side-effects November 18, 2019.

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