Apple Cider Vinegar - Entresto (Sacubitril, Valsartan) Interaction
Herbal: Apple Cider Vinegar
Also Known As: ACV, Cider Vinegar, Vinagre de Manzana, Vinagre de Sidra de Manzana, Vinaigre de Cidre
Drug: Sacubitril, Valsartan
Brand names:
Entresto
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Jul 22, 2023
Interaction Details
Sacubitril, Valsartan is classified as belonging to the following category: Diuretic Drugs
Theoretically, concomitant use of apple cider vinegar with diuretic drugs might increase the risk of hypokalemia.
A case of hypokalemia related to chronic use of apple cider vinegar has been reported. There is some concern that people taking apple cider vinegar along with potassium depleting diuretics might have an increased risk for hypokalemia.
Interaction Rating
Likelihood of Occurrence
PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists
Pharmacist Analysis
Using apple cider vinegar with diuretic drugs might be dangerous and could lead to low potassium levels in the blood, which is called hypokalemia. This is because both apple cider vinegar and diuretic drugs can cause your body to lose potassium.
However, it's important to note that the evidence for this potential interaction between apple cider vinegar and diuretic drugs only goes as far as case studies. This means that there have only been a few reported cases of hypokalemia related to the use of these two substances together, and more research is needed to fully understand the extent of this risk.
It's unlikely that the short-term use of ACV has a significant risk of hypokalemia, even if you are taking a diuretic that depletes potassium. Nevertheless, if you are, be sure to talk to your doctor before taking ACV as a dietary supplement.
References
- Lhotta K, Hofle G, Gasser R, Finkenstedt G. Hypokalemia, hyperreninemia, and osteoporosis in a patient ingesting large amounts of cider vinegar. Nephron 1998;80:242-3.
Apple Cider Vinegar Overview
Apple cider vinegar, or ACV, is the fermented juice from crushed apples. ACV is typically made by crushing apples and adding yeast and bacteria to the mixture, which ferments the sugars in the apples and turns them into alcohol. This alcohol is then converted into vinegar through a second fermentation process. ACV contains pectin, vitamins, minerals, and acid in the form of acetic acid or citric acid. While it is most popularly used in salad dressings and cooking, apple cider vinegar has been used medicinally as it is thought to have antioxidant, anti-inflammatory, and antimicrobial properties, and may help to boost the immune system.
Sacubitril, Valsartan Overview
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The combination of valsartan and sacubitril is usually used in combination with other medications to lower the risk of death and hospitalization in adults with certain types of heart failure. The combination of valsartan and sacubitril is also used to treat certain types of heart failure in children 1 year of age and older. Valsartan is in a class of medications called angiotensin II receptor antagonists. It works by blocking the action of certain natural substances that tighten the blood vessels, allowing the blood to flow more smoothly and the heart to pump more efficiently. Sacubitril is in a class of medications called neprilysin inhibitors. It works to help control blood volume.
Apple Cider Vinegar - More Interactions
Apple Cider Vinegar interacts with 160 drugs
Interaction Rating Key
These severity listings are for informational use only. Never start, stop or otherwise change your therapy before speaking with your provider.
| Major | The combined use of these agents is strongly discouraged as serious side effects or other negative outcomes could occur. |
| Moderate | Use cautiously under the care of a healthcare professional or avoid this combination. A significant interaction or negative outcome could occur. |
| Minor | Be aware that there is a chance of an interaction. Watch for warning signs of a potential interaction. |
| Unknown | No interactions have been reported or no interaction data is currently available. |
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Parts of this content are provided by the Therapeutic Research Center, LLC.
DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.
© 2021 Therapeutic Research Center, LLC
Drug descriptions are provided by MedlinePlus.
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In addition to being a clinical pharmacist specializing in pharmacotherapy, Dr. Brian Staiger is a registered herbalist through the American Herbalist Guild. He has combined his passion for pharmacy practice with the study of medical ethnobotany to improve patient care. Feel free to reach out about any of your herbal or medication questions!
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