Entresto, sacubitril/valsartan
Named-patient access overview. Entresto is coordinated by Reserve Meds for international patients through cross-border sourcing coordinated with your treating doctor.
This page is informational, not medical advice.
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About Entresto
Entresto (sacubitril/valsartan) is a fixed-dose oral combination developed by Novartis for chronic heart failure. The US Food and Drug Administration first approved it in July 2015 to reduce the risk of cardiovascular death and hospitalisation for heart failure in adults with chronic heart failure with reduced ejection fraction (HFrEF). The label later broadened to encompass adult chronic heart failure across the ejection-fraction spectrum, including patients with preserved ejection fraction (HFpEF), with the strongest benefits seen in patients with reduced or mid-range ejection fraction. Entresto is also approved in pediatric heart failure with reduced systemic-ventricle ejection fraction (down to age one year). It is taken twice daily as an oral tablet, with available strengths 24/26 mg, 49/51 mg, and 97/103 mg, titrated to a target dose.
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Entresto is the first of a class called angiotensin receptor-neprilysin inhibitors (ARNI). The sacubitril component, through its active metabolite, inhibits neprilysin and raises levels of natriuretic peptides that drive vasodilation, natriuresis, and reductions in ventricular remodelling. The valsartan component blocks the angiotensin II type 1 receptor. Together they address two complementary axes of neurohormonal activation in heart failure. Major guideline bodies now place ARNI therapy among the foundational pillars of HFrEF treatment, alongside beta-blockers, mineralocorticoid receptor antagonists, and SGLT2 inhibitors.
For international patients, Entresto is registered in many of the markets Reserve Meds serves, but supply continuity, reimbursement, and out-of-pocket arrangements vary. Patients sometimes pursue US-sourced Entresto via named-patient or personal-import pathways when local supply is unavailable, when their cardiologist has specifically prescribed the US brand, or when continuity with a US treatment plan is the priority. Reserve Meds coordinates that sourcing from a US-licensed pharmaceutical wholesale partner.
How Reserve Meds coordinates Entresto
- Patient or treating cardiologist submits a named-patient request through our intake.
- The clinical team reviews appropriateness of Entresto for the patient's heart-failure profile and concomitant therapy.
- The treating cardiologist issues a prescription and a written clinical justification.
- Country-specific named-patient or personal-import documentation is prepared.
- Entresto is sourced from a US-licensed pharmaceutical wholesale partner with full serial-number traceability.
- The shipment is coordinated to the patient's physician, pharmacy, or home address, depending on the country pathway.
A single case coordinator stays with the case from intake through delivery. The coordinator owns documentation, timeline, customs clearance, and confirmation of receipt.
Clinical trials and expanded access
On 17 October 2026 we searched ClinicalTrials.gov, the clinical study registry of the US National Library of Medicine, for studies that list sacubitril and valsartan as an intervention. The search found studies that are recruiting or not yet recruiting. See the current list on ClinicalTrials.gov.
Whether a patient can join a trial or an expanded access program is decided by the study team or the manufacturer, together with the treating doctor. Reserve Meds does not run trials or supply investigational medicines. We can help you and your doctor read a listing and understand the route.
Access by country
Reserve Meds publishes a detailed country deep-dive for Entresto in every market we coordinate. Each page below covers the destination-country regulatory pathway, how quotes work, indicative timelines, physician-credential requirements, and cold-chain handling. Tap any country to read the full deep-dive.
What patients typically ask about Entresto
Which heart-failure patients is Entresto approved for? The US label covers chronic heart failure in adults, with the most consistent benefit in patients with reduced ejection fraction. It is also approved in pediatric heart failure with reduced systemic-ventricle ejection fraction in patients one year of age and older. The treating cardiologist determines suitability based on ejection fraction, symptoms, blood pressure, kidney function, and concomitant therapy.
How is Entresto different from an ACE inhibitor or ARB alone? Entresto adds neprilysin inhibition to angiotensin receptor blockade, raising endogenous natriuretic peptide levels and producing additional reductions in cardiovascular death and heart-failure hospitalisation versus an ACE inhibitor in pivotal trials. Patients switching from an ACE inhibitor must observe a washout period to reduce the risk of angioedema; the prescribing cardiologist will manage the transition.
Is Entresto registered in my country? In several Reserve Meds markets sacubitril/valsartan is registered and locally available. Pricing, reimbursement, and continuity of supply vary. The country deep-dives linked above describe local registration status, the documentation route for importing US-branded Entresto when needed, and indicative timelines.
How is Entresto shipped? Entresto is an oral tablet at ambient temperature; cold-chain handling is not required. Standard international logistics with documentation review apply.
What does a course cost? Patients pay for the medicine plus Reserve Meds coordination, regulatory documentation, and shipping. Costs vary by destination because of duties, VAT, and country-specific documentation. Every case gets a written custom quote before you commit.
Clinical and safety notes
Entresto carries a boxed warning against use during pregnancy because of risk of fetal toxicity. Contraindications include concomitant use with an ACE inhibitor (must observe a 36-hour washout between agents) and a history of angioedema related to prior ACE inhibitor or ARB therapy. Clinical considerations include hypotension, hyperkalaemia, declines in kidney function (particularly in patients with renal artery stenosis or volume depletion), and angioedema (rare but clinically important, with higher reported incidence in Black patients than in non-Black patients in trials). Common adverse reactions include hypotension, hyperkalaemia, cough, dizziness, and renal impairment.
Reserve Meds does not replace the prescribing relationship. We coordinate access to a US-licensed medicine for a patient already under physician care. Patients who experience swelling of the face, lips, tongue, or throat, breathing difficulty, chest pain, fainting, or significant changes in urination should contact their treating cardiologist or seek emergency care promptly. Reserve Meds is not an emergency service.
How Entresto fits a heart-failure treatment plan
Contemporary heart-failure care for patients with reduced ejection fraction is built around four foundational pillars: a renin-angiotensin-system agent (ideally an ARNI such as Entresto), an evidence-based beta-blocker, a mineralocorticoid receptor antagonist, and an SGLT2 inhibitor. Major guideline bodies in the United States and Europe now describe the goal as initiating and titrating all four pillars early in eligible patients, alongside diuretic therapy as needed for congestion and device or rhythm management where indicated. Entresto specifically replaced ACE inhibitors and angiotensin receptor blockers as the preferred neurohormonal agent in HFrEF after pivotal trials demonstrated additional reductions in cardiovascular death and heart-failure hospitalisation.
For patients with mid-range or preserved ejection fraction, the evidence base is more nuanced but still meaningful. Trials including PARAGON-HF have informed expanded labelling and a more inclusive view of which patients may benefit from ARNI therapy, particularly those at the lower end of the preserved-EF spectrum. The treating cardiologist makes the prescribing decision based on ejection fraction, symptoms, blood pressure, renal function, potassium, and the patient's response to existing therapy. Initiation involves careful attention to dose, washout from any prior ACE inhibitor, and monitoring of blood pressure, electrolytes, and kidney function after titration steps.
Continuity matters in chronic heart failure. A patient who has been initiated and titrated on Entresto by a treating cardiologist, who is responding clinically, and who is travelling, relocating, or living outside the US often prefers to stay on the same agent at the same dose rather than switch to a different brand or formulation mid-stream. Reserve Meds exists to make that continuity practical, with the regulatory and logistical scaffolding the patient would otherwise have to assemble alone. Patients should not stop or change Entresto without speaking to their cardiologist, including during shipping delays; we coordinate with the prescribing physician to bridge gaps when they arise.
What is included in a Reserve Meds Entresto case
A Reserve Meds case for Entresto covers the full chain from intake to delivery. The named case coordinator confirms that the prescription, clinical justification, and patient identity documentation are complete before any procurement step begins. The regulatory team prepares country-specific named-patient or personal-import paperwork tailored to the destination, including translations where required. The procurement team places the order with a US-licensed pharmaceutical wholesale partner and confirms full serial-number traceability. The logistics team handles international shipping, customs documentation, and final-mile delivery, with proof-of-delivery returned to the case file. The coordinator remains the single point of contact for the patient and the treating cardiologist throughout the case and across any subsequent refills.
Start a request for Entresto
Send us the medicine and your country. We reply within one business day with case-specific feasibility, timeline, and a formal quote.
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Entresto (sacubitril/valsartan) is FDA-approved per the current US label (Novartis, DailyMed). Reserve Meds coordinates US-sourced supply via DSCSA-compliant specialty channels for international patients under named-patient pathways. Prescribing decisions remain with the treating cardiologist.
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Frequently asked questions
How can I get Entresto if it is not approved or available in my country?
Reserve Meds coordinates US-sourced Entresto for patients through a legal named-patient pathway, working with your treating doctor. Your treating physician provides the prescription and clinical justification; Reserve Meds prepares the named-patient documentation for your country and arranges DSCSA-compliant US sourcing and delivery to your physician or hospital pharmacy.
Can I access Entresto through a named-patient import?
Often, yes. Named-patient access (sometimes called personal import) is the legal route we use for FDA-approved medicines such as Entresto. It is different from compassionate use, which covers investigational medicines through the manufacturer's own program; we do not supply investigational medicines. Eligibility and paperwork depend on the regulator in your country, and Reserve Meds maps the specific pathway for each market it coordinates.
Do I need a prescription to access Entresto through Reserve Meds?
Yes. Reserve Meds is not a pharmacy and does not prescribe. A valid prescription and clinical justification from your treating physician are required, and all clinical decisions remain with your physician.
How does Reserve Meds deliver Entresto to a patient?
Medicines are supplied through a US-licensed pharmaceutical wholesale partner, and Reserve Meds coordinates delivery of Entresto to your treating physician or hospital pharmacy, with appropriate handling for the product.
How long does it take, and what does Entresto cost through Reserve Meds?
After a short intake, the clinical team responds within one business day with case-specific feasibility, an indicative timeline, and a formal written quote. Cost depends on the destination, the prescribed regimen, and the duration of therapy, and is confirmed in writing before anything proceeds.
How do I start a request for Entresto?
Submit a 60-second intake through the Reserve Meds patient portal, or message our team on WhatsApp. We reply within one business day. On WhatsApp we usually reply the same day.