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Is there a cheaper alternative to Entresto?

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About EntrestoAlternativesAbout heart failureHeart healthSummary
Entresto is a brand-name medication that doctors use to treat heart failure. It is available by prescription only. While it is an effective drug, it can be expensive as there is no generic option available.
Medically reviewed by Alyssa Walton, PharmD
Written by D. M. Pollock
Updated on

Entresto is a combination drug containing the active ingredients sacubitril and valsartan. Doctors often prescribe this oral tablet drug to help treat long-term or chronic heart failure.

There is currently no generic version of the drug available. A generic drug contains the same active ingredients as a brand-name medication, but they are often less expensive.

Because Entresto is currently the only version available, it can make taking this drug costly.

What is Entresto, and how does it work?

Adult female sitting on the floor of her apartment tying the shoelace on her right foot and possibly wondering is there a cheaper alternative to entresto
Photography by VorDa/Getty Images

Entresto is a type of heart failure medication that is a part of the group of medications called angiotensin receptor–neprilysin inhibitors (ARNIs).

ARNIs like Entresto contain two active ingredients — sacubitril and valsartan. These drugs are effective in treating heart failure with preserved ejection fraction.

Ejection fraction is the amount of blood your heart pushes out the ventricle every time it pumps. The more blood your heart pumps out, the healthier it is. According to the American Heart Association (AHA), an ejection fraction of 40% is evidence of heart failure.

Preserved ejection fraction is a condition where your ventricles do not relax fully and become stiff, meaning insufficient blood flows into them. This reduces your ejection fraction.

ARNIs like Entresto relax your blood vessels, making it easier for your heart to pump blood around your body. Over time, they can help improve ejection fraction.  

Are there any Entresto alternatives?

Research indicates that the active ingredients in Entresto are likely better at treating specific heart failure caused by preserved ejection fraction.

However, before Entresto received approval from the Food and Drug Administration (FDA), healthcare professionals were successful in treating this type of heart failure with other types of medication. These include angiotensin-converting enzyme (ACE) inhibitors and beta-blockers.

Here are some alternative generic medications prescribed to treat heart failure.

  • Enalapril: This ACE inhibitor medication is available as the generic enalapril and as the brand name Vasotec. These medications work by relaxing blood vessels, which lowers pressure and increases blood supply.
  • Valsartan: This is an angiotensin receptor blocker (ARB) that is available as generic valsartan and as the brand name Diovan. It works to help treat heart failure by blocking the substance your body naturally produces to tighten blood vessels. This helps to relax your blood vessels and increase blood flow.
  • Carvedilol: Carvedilol is a generic beta-blocker medication also available under the brand name Coreg. This drug works to help improve heart failure by slowing your heart rate, making it easier for your heart to pump more blood around your body.

Do alternatives work in the same way?

The way these medications work will vary. They act to reduce blood pressure or improve ventricular output in a variety of ways. For example, beta-blockers reduce your heart rate, while ACE inhibitors relax your blood vessels.

Most heart failure medications have not been studied in comparison to Entresto.

This does not mean they will be less effective for you than Entresto, but the effects can differ depending on your health condition.

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What is heart failure?

Heart failure, or congestive heart failure, is the condition that develops when your heart cannot pump blood effectively around your body. This can be because your heart does not fill up with enough blood or the muscle is too weak to pump blood around the body effectively. Heart failure can affect both adults and children.

You may not notice any symptoms of heart failure until your condition is advanced. However, symptoms can include:

  • tiredness
  • fatigue
  • shortness of breath
  • lower body fluid buildup

It can cause other health conditions if you do not receive treatment. For example, it can lead to damage to your kidneys and liver.

It can also cause:

  • an irregular heartbeat
  • pulmonary hypertension
  • sudden cardiac arrest
  • heart valve disease

Taking care of yourself and your heart

Small lifestyle adaptations can make a big impact on your heart health. Working to incorporate some of the following modifications will positively support your quality of life, even with a heart failure diagnosis.


Entresto is a type of combination medication effective for treating heart failure that is the result of a reduction in your ejection fraction.

If Entresto is too expensive, there may be suitable alternatives that a doctor or healthcare professional can recommend.

Lifestyle adaptations, including getting regular physical activity such as exercise and following a heart-healthy diet, can help improve your heart health.

Download the free Optum Perks Discount Card to save up to 80% on some prescription medications.

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