Supplements and Sacubitril/valsartan.
Sacubitril/valsartan, sold under the brand name Entresto, is classified under "hypertension and heart failure" in the BNF.
Sacubitril/valsartan (brand names Entresto) sits at NHSBSA prescribing rank 123 in the 2024/25 PCA statistics. The BNF classifies it under "hypertension and heart failure". This means it sits outside the high-volume therapeutic classes (statins, PPIs, ACE inhibitors, SSRIs) where supplement-interaction surfaces are densely studied, and the published evidence base for specific supplement pairs is correspondingly thinner. Where interactions are documented in the Distil database, they are listed below with their clinical-reference citation; where pairs have not been explicitly assessed, the missing-item form at the bottom of the page routes them into our next curation pass. Anyone combining Sacubitril/valsartan with a regular supplement stack benefits from explicit GP or pharmacist awareness rather than assuming no interaction exists by default.
Below are the 2 documented pairs we have explicitly assessed against Sacubitril/valsartan in the Distil database: 1 red and 1 amber. The pairs cluster around 2 mechanisms: Additive hyperkalaemia (raised potassium) and Reduced renal lithium clearance. Every call is cited to either a clinical reference (PMID) or the British National Formulary. Anything not on this list is either still to be assessed or beyond our database scope. The checker beneath surfaces assessments by supplement, and the missing-item form at the bottom of the page routes any uncatalogued supplement into our next curation pass.
Documented interactions
Last reviewed 14 June 2026. Each interaction below lists the evidence its assessment drew on: some rest on studies of the exact pair, others on mechanism evidence, where a citation may support one part of the reasoning rather than the exact combination. The evidence line on each entry says which.
Additive hyperkalaemia (raised potassium)
Red Does Potassium interact with ?
Sacubitril/valsartan (Entresto) contains valsartan, which raises blood potassium by reducing how much the kidneys pass out. A potassium supplement adds more potassium on top. Together they can push potassium high enough to affect the heart rhythm, which can be dangerous. Do not take a potassium supplement alongside sacubitril/valsartan unless your specialist has specifically advised it and is checking your blood potassium.
Evidence: Supported by human study data.
Reduced renal lithium clearance
Amber Does Lithium Orotate interact with ?
Sacubitril-valsartan (a heart-failure tablet that contains an angiotensin receptor blocker) can reduce how well the kidneys clear lithium, which raises the lithium level in the blood. With prescription lithium this type of medicine has caused toxicity in reported cases. At the small amount of lithium in a typical lithium orotate supplement (around 5 mg) the effect is expected to be very small; it matters more for higher-strength products (around 20 mg) and for anyone whose kidney function is reduced. Check with your pharmacist or GP before using a lithium supplement.
Evidence: Based on an established mechanism, with no direct study of this exact combination yet.
Reviewer-flagged: awaiting clinical-reviewer sign-off.
What this list does not say. Pairs not flagged here are not implicitly safe. They are either not yet in our database, or fall outside our inclusion scope (food-supplement interactions only; for drug-drug interactions, the BNF is authoritative). Use the checker below to surface any supplement, and submit a missing item if you take something we have not catalogued.
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How we grade severity, choose what's in scope, and what we exclude.
Every call on this page is reasoned. We publish the full rubric for severity tiers, the medication inclusion logic, the evidence grades we accept, and what we deliberately leave out. About three thousand words. Worth reading once if you use this tool more than occasionally.
Read the full methodologyA full supplement review, built around you, not a generic stack.
The free checker answers one interaction question at a time. A Distil report reviews the bigger picture: your goals, diet, medications, current supplements and any blood results you provide, then shows what appears worth keeping, changing, adding or leaving out.
- what your diet already covers, so you are not adding a capsule for something food is already handling
- which evidence-graded compounds are worth considering for your goals, and which were considered but left out
- what to keep, change or stop from what you already take, plus the order to introduce anything new
- how your medications and complete supplement stack fit together, with daily timing and a clear point for reassessment
The interaction check is one section of the full report. You also get the reasoning behind each recommendation and the evidence references used.
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