Medication · other hypertension and heart failure

Supplements and Sacubitril/valsartan.

Every documented pair, every citation. Below: 2 documented pairs grouped by mechanism.

Sacubitril/valsartan, sold under the brand name Entresto, is classified under "hypertension and heart failure" in the BNF.

Sacubitril/valsartan (UK 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

Additive hyperkalaemia (raised potassium)

Red Potassium

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.

PMID 25176015 · PMID 21438068 · PMID 31800080 · BNF: Sacubitril-valsartan

Reduced renal lithium clearance

Amber Lithium Orotate

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.

PMID 11305712 · PMID 8521679 · PMID 34146638 · PMID 18072162 · BNF: Lithium

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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For adults over 18. This tool gives evidence-graded information, not medical advice. Always discuss changes with your GP, especially if you take any medication, are pregnant, breastfeeding, or have a serious health condition.

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How we grade severity, choose what's in scope, and what we exclude.

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Distil's interactions database is reviewed and updated every quarter. We grade evidence transparently and publish our methodology, including every database change, at /about/methodology. This tool is information, not a substitute for clinical judgement. If you take medication and supplements together, your GP or pharmacist can review your full regimen against your medical history. If you want a full personalised stack reasoned against this same database, the Distil report is the next step up.