Can Entresto be cut in half or split?

The manufacturer of Entresto (sacubitril and valsartan) does not make a recommendation about splitting or cutting this drug in half in their package insert. Entresto is a film-coated tablet that contains two different medicines, sacubitril and valsartan, used to treat a serious heart condition known as heart failure.

The FDA makes recommendations about pill-splitting. If a tablet is FDA-approved to be split, this information will be printed in the “How Supplied” section of the package insert. Also, the tablet will be scored with a mark indicating where to split it. Ask your doctor or pharmacist before you split or crush any medication if you are not sure.

If a medicine does not include this information in the package insert, the FDA has not studied it to ensure that the two halves of a split tablet contain the same amount of drug or work similarly to the whole tablet. Taking half of a tablet of Entresto for heart failure might contain uneven amounts of medicine and could be dangerous.

In addition, the Entresto tablet does not contain a score in the middle of the tablet, meaning that it is not usual practice to split this pill. Tablets that are not scored have not been studied by the FDA for safety when split in half.

The manufacturer produces three different strengths of Entresto so that splitting tablets is not really necessary. Your doctor can prescribe the appropriate strength if your dose changes. Also, if tablets are not available in the prescribed strength or if you or your child cannot swallow tablets, your pharmacist can prepare Entresto as a liquid suspension from the tablets.

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