Entresto (sacubitril/valsartan) is a medication prescribed to manage certain types of heart failure, a condition where the heart struggles to pump blood effectively. Administering medications precisely as directed ensures their intended benefits and patient safety. Altering administration methods can change a drug’s effectiveness and lead to unintended consequences.
How Entresto Works and Its Tablet Design
Entresto is a combination medication containing two active substances: sacubitril and valsartan. Sacubitril inhibits neprilysin, an enzyme that breaks down natural peptides. By blocking neprilysin, sacubitril increases these beneficial peptides, reducing heart strain and promoting fluid removal. Valsartan, an angiotensin II receptor blocker, relaxes blood vessels and assists the kidneys in removing excess water and salt. This dual action improves the heart’s pumping ability and overall cardiovascular function.
Entresto is provided as film-coated, unscored, ovaloid tablets in various strengths. The film coating is integral to their design, protecting active ingredients and influencing how the medication is released and absorbed. This formulation ensures drug components are delivered in a controlled manner for optimal therapeutic effect.
Consequences of Altering Entresto Tablets
Altering Entresto tablets by crushing, chewing, or otherwise modifying them can lead to several negative outcomes. The film coating, designed to protect the tablet’s contents, can be damaged when crushed. This damage may expose the active ingredients to stomach acids, potentially causing them to degrade prematurely. Such degradation can reduce the amount of medication that is absorbed, making the treatment less effective for managing heart failure.
Crushing can disrupt the precise delivery of sacubitril and valsartan, which is important for their synergistic action. When the tablet’s integrity is compromised, the medication might be absorbed too rapidly or inconsistently. This uncontrolled absorption can lead to higher-than-intended concentrations in the bloodstream, increasing the potential for side effects such as low blood pressure or kidney issues.
Crushing also makes it difficult to ensure the patient receives the exact prescribed dose. Drug particles can be lost during the process, or the powder may not be evenly distributed if mixed with food or liquid. This loss of dosage precision means the patient might not receive enough medication to treat their heart failure, or they could inadvertently receive too much.
Approaches for Swallowing Difficulties
Individuals who find swallowing pills challenging have several safe strategies. One technique involves taking a sip of water, placing the pill on the tongue, then taking another sip and swallowing while tilting the chin towards the chest. This “lean forward” method facilitates the swallowing reflex. Another option is the “pop bottle” method, where the tablet is placed on the tongue, and water is consumed from a bottle with a narrow opening, creating suction that aids swallowing.
Various products are designed to assist with pill swallowing, such as specialized cups or gels that lubricate the throat. For some medications, using soft foods like applesauce or yogurt can help carry the pill down; however, this should only be done if specifically approved, as food interactions can occur. These methods are for intact pills and do not involve altering the tablet.
If swallowing difficulties persist, alternative formulations of Entresto are available through a healthcare professional. A pharmacist can prepare an oral suspension by precisely crushing Entresto tablets and mixing them into a liquid. There are also Entresto Sprinkle oral pellets, which come inside a capsule that can be opened and sprinkled onto soft food, though the pellets themselves should not be chewed or crushed.
Importance of Professional Guidance
Consulting a healthcare professional (doctor or pharmacist) is essential before adjusting medication administration. These professionals provide personalized advice based on a patient’s specific needs and the medication’s properties. They can discuss safe alternatives for swallowing difficulties or explore whether a pharmacist-prepared liquid formulation is appropriate. Seeking professional guidance ensures the patient receives correct and effective treatment for their heart condition while minimizing potential risks.