sacubitril/valsartan vs spironolactone
Side-by-side comparison of sacubitril/valsartan and spironolactone. Data from FDA drug databases (Orange Book, NDC Directory, recalls, shortages) covering 20,000+ approved drugs, plus CMS pricing; see our methodology.
minor Known Drug Interaction
7.2 Potassium-Sparing Diuretics As with other drugs that block angiotensin II or its effects, concomitant use of potassium-sparing diuretics (e.g., spironolactone, triamterene, amiloride), potassium supplements, or salt substitutes containing potassium may lead to increases in serum potassium [see Warnings and Precautions (5.5)] .
Recommendation: Your doctor should check your blood potassium levels regularly. Avoid using potassium supplements or salt substitutes that contain potassium unless your doctor tells you otherwise.
Entresto
Aldactone
Entresto is a medicine that combines two drugs to help adults and children with heart failure. It helps to lower the risk of heart problems and hospital visits.
Spironolactone is a medicine that helps remove extra fluid from your body and lower blood pressure. It also helps your heart work better if you have heart failure.
Entresto is used to treat heart failure in adults and children aged one year and older. It is for people whose heart does not pump blood well enough. Entresto can help reduce hospital visits and the risk of death from heart problems.
Spironolactone is used to treat heart failure by reducing fluid build-up and helping you live longer. It also treats high blood pressure, which can lower your chance of having a stroke or heart attack. This medicine can also manage fluid build-up caused by liver problems or a kidney problem called nephrotic syndrome. It can also treat a condition where your body makes too much of a hormone called aldosterone.
Entresto works by blocking a substance in your body that can worsen heart failure. It also relaxes your blood vessels, which helps your heart pump blood more easily. This combination helps to improve how well your heart works.
Spironolactone belongs to a class of drugs called aldosterone antagonists. It works by blocking the effects of aldosterone, a hormone that causes your body to hold onto salt and water. By blocking aldosterone, spironolactone helps your body get rid of extra fluid and salt, which lowers blood pressure and reduces strain on the heart.
- • Low blood pressure
- • High potassium levels in the blood
- • Cough
- • Dizziness
- • Kidney problems
- • Breast enlargement in men
- • Dizziness
- • Headache
- Low blood pressure 11,457
- Death 9,093
- Shortness of breath 8,895
- Feeling dizzy 8,621
- Feeling tired 8,606
- Difficulty breathing 10,389
- Tiredness 8,179
- Feeling sick to your stomach 7,818
- Loose stools 7,416
- Sudden kidney damage 6,785
Entresto can harm an unborn baby, even causing death. If you are pregnant or become pregnant, stop taking Entresto right away and tell your doctor.
Spironolactone can cause your potassium levels to get too high, which can be dangerous. Your doctor will check your potassium levels regularly, especially if you have kidney problems or are taking other medicines that can raise potassium. This medicine can also cause low blood pressure or make kidney problems worse. Tell your doctor if you have side effects.
Entresto can cause serious harm or death to an unborn baby. Do not take this medicine if you are pregnant. Breastfeeding is not recommended while taking Entresto.
Spironolactone may affect the sex organs of a baby boy if taken during pregnancy. Talk to your doctor if you are pregnant or plan to become pregnant. It is not known if spironolactone passes into breast milk, so talk to your doctor about the best way to feed your baby if you are taking this medicine.
How to Read This sacubitril/valsartan vs spironolactone Comparison
sacubitril/valsartan is classified in the Neprilysin Inhibitor / ARB Combination drug class, while spironolactone sits within the Potassium-Sparing Diuretic / Aldosterone Antagonist class. Drugs from different classes work through distinct mechanisms, so a head-to-head comparison illustrates trade-offs rather than equivalence. Both drugs are prescription-only, so a licensed provider must authorize use.
Adverse event totals above are pulled from the FDA's Adverse Event Reporting System (FAERS). For these top-ranked reactions alone, sacubitril/valsartan has 46,672 submissions while spironolactone has 40,587. Those figures reflect cumulative reporting volume, not per-patient risk, so older, widely dispensed drugs typically look worse on count alone. These two drugs have a known minor interaction flagged in FDA labeling, attributed to both of these medications cause the kidneys to keep potassium in the body instead of flushing it out. taking them together can cause potassium to build up to unsafe levels in your blood.. Serious warnings, pregnancy guidance, and contraindications can differ even when indications overlap.
A table cannot substitute for clinical judgment. Effectiveness, tolerability, drug-drug interactions with your other medications, kidney and liver function, pregnancy status, insurance formulary, and price all feed into a decision that only a licensed prescriber can make responsibly. Data here is sourced from FDA Structured Product Labels (SPL) and FAERS, both of which update as manufacturers and clinicians submit new information. This page is for educational purposes only, is not medical advice, and should not be used to self-switch between sacubitril/valsartan and spironolactone - always consult your physician or pharmacist first.
Important: This comparison is for informational purposes only. Drug effects vary between individuals. Always consult your doctor or pharmacist for personalized medical advice.