What supplements should not be taken with Entresto? If you are taking Entresto, avoid potassium, St. John’s Wort, magnesium & blood pressure-lowering herbs to prevent dangerous interactions. Always consult your doctor before any undertakings.
Why Some Supplements Interfere with Entresto
Entresto contains two active ingredients:
- Sacubitril – Helps reduce strain on the heart.
- Valsartan – An angiotensin receptor blocker (ARB) that lowers blood pressure.
Because of its mechanism, Entresto can interact with supplements that:
- Increase potassium levels (risk of hyperkalemia).
- Lower blood pressure too much (risk of dizziness or fainting).
- Affect kidney function (since Entresto is partly cleared by the kidneys).
- Interfere with drug metabolism (altering Entresto’s effectiveness).
Supplements to Avoid While Taking Entresto
1. Potassium-Rich Supplements
Entresto can raise potassium levels, and combining it with potassium supplements increases the risk of hyperkalemia (dangerously high potassium), which can cause irregular heartbeats or cardiac arrest.
Avoid:
- Potassium chloride supplements
- Potassium-sparing herbs (e.g., licorice root, dandelion, nettle)
- Salt substitutes containing potassium (e.g., Morton Lite Salt, NoSalt)
Safer Alternative:
- Most people get enough potassium from food (bananas, spinach, sweet potatoes). Check with your doctor before increasing intake.
2. Magnesium and Calcium Supplements
High doses of magnesium or calcium can affect blood pressure and electrolyte balance, potentially worsening Entresto’s effects.
Potential Risks:
- Magnesium – May enhance blood pressure-lowering effects, leading to dizziness.
- Calcium – Can interfere with valsartan’s absorption in some cases.
Avoid High Doses Of:
- Magnesium oxide, citrate, or glycinate (unless prescribed)
- Calcium carbonate or citrate supplements (unless needed for bone health)
Safer Alternative: Moderate dietary intake (leafy greens, nuts, dairy) is usually safe. Consult your doctor before supplementing.
3. St. John’s Wort
St. John’s Wort herbal supplement is used for depression, but can reduce Entresto’s effectiveness by speeding up its metabolism in the liver.
Why It’s Risky: May lower Entresto’s blood concentration → Reduced heart failure benefits. Avoid Completely.
4. Coenzyme Q10 (CoQ10)
While CoQ10 is often taken for heart health, it may enhance blood pressure-lowering effects, increasing dizziness or fainting.
Potential Interaction: Mild, but caution is needed in those already on blood pressure medications.
Safer Alternative: Discuss with your doctor before using CoQ10.
5. Fish Oil (Omega-3 Fatty Acids)
High doses of fish oil may slightly lower blood pressure, which could amplify Entresto’s effects.
Potential Risk: Increased dizziness or lightheadedness.
Safer Approach: Low to moderate doses (1-2g/day) are usually safe, but consult your doctor.
6. Garlic Supplements
Garlic has natural blood pressure-lowering effects, which may compound Entresto’s impact.
Potential Risk: Excessive blood pressure drop → Dizziness or fainting.
Safer Alternative: Cooking with garlic is fine, but avoid high-dose supplements.
7. Hawthorn Berry
Often used for heart health, hawthorn can lower blood pressure and interact with Entresto’s effects.
Why It’s Risky: It may cause additive blood pressure reduction. Avoid it unless approved by your doctor.
8. Ginkgo Biloba
Ginkgo may affect circulation and blood pressure, potentially interacting with Entresto.
Potential Risk: Increased dizziness or irregular blood pressure. Avoid Unless Medically Supervised.
General Guidelines for Supplement Use with Entresto
- Always Consult Your Doctor before starting any new supplement.
- Monitor Potassium Intake – Avoid excess potassium from supplements or salt substitutes.
- Watch for Dizziness – Some supplements may enhance blood pressure effects.
- Check for Kidney Impact – Supplements like high-dose vitamins or herbs may affect kidney function.
Knowing what supplements should not be taken with Entresto is essential for preventing dangerous interactions. Potassium-rich supplements, St. John’s Wort, magnesium, and certain heart-health herbs (like hawthorn or garlic) should be avoided or used cautiously. Always discuss supplements with your healthcare provider to ensure they won’t interfere with Entresto’s effectiveness or safety.
By following these guidelines, you can maximize the benefits of Entresto while minimizing risks. Stay informed, stay safe!