Can I crush Enteresto (generic name not specified)?

Crushing Entresto: Guidelines for Administration

Yes, Entresto tablets can be crushed and mixed with water or soft food when patients are unable to swallow tablets whole, as specifically indicated in the FDA drug label. 1

Official Administration Options for Entresto

The FDA label for Entresto provides clear guidance on administration options for patients who cannot swallow tablets:

• For adults: Tablets may be crushed and mixed with liquid or soft food when needed 1
• For pediatric patients and adults with swallowing difficulties: An oral suspension can be prepared using Entresto 49/51 mg tablets 1

Preparation of Oral Suspension (Official Method)

When crushing is necessary, the FDA label recommends preparing a proper suspension:

1. Transfer eight tablets of Entresto 49/51 mg into a mortar
2. Crush tablets into a fine powder using a pestle
3. Add 60 mL of Ora-Plus® and triturate for 10 minutes
4. Add 140 mL of Ora-Sweet® SF and triturate for another 10 minutes
5. Transfer to a clean 200 mL amber bottle
6. The prepared suspension can be stored for up to 15 days at room temperature 1

Important Considerations When Crushing Medications

When crushing Entresto or any medication, several precautions should be observed:

• Immediate administration: Crushed medications should be administered immediately after preparation 2
• Complete consumption: Ensure the entire dose is consumed 2
• Tube administration: If administering through an enteral tube, flush with at least 30 mL of water before and after administration 2
• Exposure risk: The person crushing the medication may be exposed to drug particles, so proper precautions should be taken 3

Potential Risks of Crushing Medications (General)

While Entresto can be crushed, it's important to understand the general risks associated with crushing medications:

• Altered absorption: Crushing some medications can alter drug absorption, potentially leading to overdose or underdosing 3
• Loss of special properties: Crushing extended-release or enteric-coated formulations can destroy their special properties 3, 4
• Drug degradation: Some active ingredients may degrade when exposed to light, moisture, or food 3

Best Practices for Administration

When administering crushed Entresto:

• Consult with a pharmacist before crushing any medication 2
• Use appropriate ancillaries and syringes if administering through enteral tubes 2
• Flush enteral tubes with water before and after administration 2
• If tablets emerge unchanged in stool or stomal output, crushing is appropriate 2

Conclusion

Entresto can be safely crushed for patients who have difficulty swallowing tablets, as explicitly stated in the FDA drug label. For optimal administration, follow the official preparation method for an oral suspension or consult with a pharmacist for specific guidance tailored to the patient's needs.