Can Entresto (sacubitril/valsartan) cause hypokalemia in a patient with mild cardiomyopathy and coronary artery disease?

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Entresto Does NOT Cause Hypokalemia—It Causes Hyperkalemia

Entresto (sacubitril/valsartan) is associated with hyperkalemia (elevated potassium), not hypokalemia (low potassium), and this risk is actually LOWER compared to traditional ACE inhibitors like enalapril. 1, 2

Mechanism of Hyperkalemia Risk

  • Entresto contains valsartan, an angiotensin receptor blocker (ARB) that blocks angiotensin II-dependent aldosterone release, leading to potassium retention rather than potassium loss 3
  • The neprilysin inhibitor component (sacubitril) does not directly affect potassium handling but works synergistically with the ARB component 3
  • Like all RAAS inhibitors (ACE inhibitors, ARBs, mineralocorticoid receptor antagonists), Entresto decreases potassium excretion, making hyperkalemia the concern—not hypokalemia 1

Clinical Evidence on Potassium Effects

In the landmark PARADIGM-HF trial, Entresto actually caused LESS hyperkalemia than enalapril:

  • Severe hyperkalemia (K+ >6.0 mEq/L) occurred in 2.2 per 100 patient-years with sacubitril/valsartan versus 3.1 per 100 patient-years with enalapril 2
  • Overall hyperkalemia rates were comparable between groups, but severe episodes were significantly reduced with Entresto (HR 1.37 for enalapril vs. sacubitril/valsartan, p=0.02) 2
  • Hyperkalemia was LESS common with sacubitril/valsartan compared to enalapril in multiple studies 4

Risk Factors for Hyperkalemia with Entresto

Monitor closely in patients with:

  • Chronic kidney disease, especially CrCl <30 mL/min 1
  • Concurrent use of mineralocorticoid receptor antagonists (spironolactone, eplerenone) 1, 2
  • Concurrent potassium supplements or potassium-sparing diuretics 1
  • Diabetes mellitus 1
  • Advanced age 1

Monitoring Requirements

  • Check serum potassium and renal function before initiation 1
  • Monitor potassium levels regularly during treatment, especially after dose adjustments 1
  • In patients with CrCl <30 mL/min or moderate hepatic impairment, start with reduced dose (24/26 mg twice daily) 1

Important Clinical Distinction

The confusion may arise because:

  • Diuretics (like furosemide or thiazides) commonly used WITH Entresto for heart failure DO cause hypokalemia 1
  • However, Entresto itself has the opposite effect—it promotes potassium retention 1, 3
  • When Entresto is combined with loop diuretics, the potassium-wasting effect of diuretics may partially offset the potassium-retaining effect of Entresto 5

Practical Management

For your patient with mild cardiomyopathy and coronary artery disease:

  • Expect hyperkalemia risk, not hypokalemia 1
  • Educate patient to avoid potassium supplements, salt substitutes, and high-potassium foods 1
  • Avoid NSAIDs which further increase hyperkalemia risk 1
  • If using concurrent MRA therapy, the risk of severe hyperkalemia remains lower with Entresto than with traditional ACE inhibitors 2
  • Monitor blood pressure as symptomatic hypotension is MORE common with Entresto than hyperkalemia 1, 6

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Mechanism of Action of Sacubitril/Valsartan in Heart Failure

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Research

Sacubitril/valsartan: An important piece in the therapeutic puzzle of heart failure.

Revista portuguesa de cardiologia : orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology, 2017

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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