Drug & supplement interaction

Equol + Sacubitril, Valsartan

Sacubitril, Valsartan brand name: Entresto.

Minor Interaction
Medically reviewed by · Updated September 2026
The bottom line Minor

Equol has a minor interaction with Sacubitril, Valsartan. Theoretically, equol might cause additive diuretic effects when used with diuretic drugs.

Read the full interaction report
SeverityMinor
LikelihoodUnlikely
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Equol and Sacubitril, Valsartan

Here is the interaction we found between these two, with the evidence behind it.

Minor

DIURETIC DRUGS

Why this applies to Sacubitril, Valsartan

Sacubitril, Valsartan falls under DIURETIC DRUGS — the group Equol interacts with.

Theoretically, equol might cause additive diuretic effects when used with diuretic drugs.
In vitro and animal studies suggest that equol has diuretic effects, likely via inhibition of the Na-K-Cl cotransporter.
Severity Minor Likelihood Unlikely Evidence D

Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist: in lab and animal studies, equol seemed to have a mild water-pill (diuretic) effect by nudging your kidneys to release more fluid and salt. Entresto (sacubitril/valsartan) already lowers blood volume and relaxes your blood vessels, so in theory stacking equol on top could add a little to that fluid-lowering, blood-pressure-lowering effect.

If that happened, you might feel signs of running low, like dizziness, lightheadedness when standing up, or feeling more tired than usual. I want to be honest, though: this is only a theoretical concern based on test-tube and animal work, the rating is minor, and it's considered unlikely. Still, since Entresto is a serious heart medication, please check with your pharmacist or doctor before adding equol rather than changing anything on your own.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Gimenez I, Lou M, Vargas F, et al. Renal and vascular actions of equol in the rat. J Hypertens 1997;15:1303-8. PubMed
  2. Martinez RM, Gimenez I, Lou JM, et al. Soy isoflavonoids exhibit in vitro biological activities of loop diuretics. Am J Clin Nutr 1998;68:1354S-57S. PubMed
  3. Alda JO, Mayoral JA, Lou M, et al. Purification and chemical characterization of a potent inhibitor of the Na-K-Cl cotransport system in rat urine. Biochem Biophys Res Commun 1996;221:279-85. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • 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.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Equol Also Interacts With Other Medications

Equol has 58 moderate, 74 minor known drug interactions in our database — the Sacubitril, Valsartan one above is one of them. If you take anything else, check it against the full list below.

Moderate 58 Minor 74 No known interaction 2,698 (incl. Sacubitril, Valsartan)
Taking anything else?

Check Another of Your Medications Against Equol

Covers the 2,830 medications we’ve checked against Equol. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Sacubitril, Valsartan

This page covers Equol only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Sacubitril, Valsartan page lists 249 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), American Mistletoe (major), Lithium (major) and Oleander (major).

By severity: 7 major · 206 moderate · 36 minor.

From our pharmacist’s overview on the Sacubitril, Valsartan page

“Entresto (sacubitril and valsartan) is a heart failure medicine, and heart failure patients tend to be heavy supplement users, reaching for fish oil, potassium, and herbal blood-pressure remedies. That instinct carries real risk here.”

Reviewed by 2 · Jul 18, 2026

Open the Sacubitril, Valsartan interaction page

How much people look this up

Where Equol and Sacubitril, Valsartan Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Equol
Steady interest

#869 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Sacubitril, Valsartan
Top 5%

#69 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Equol

What is Equol?

  • Menopause symptoms (hot flashes)
  • Bone health support
  • Skin aging
  • Prostate health
  • General hormone balance

Equol is a compound made in the gut when some people break down soy isoflavones, and it is also sold as a supplement. Early research links it to possible benefits for menopause symptoms and bone or skin health, but the evidence is still limited and far from proven. Talk with your pharmacist or doctor before using it, and avoid it during pregnancy and breastfeeding.

Read the full Equol monograph & all interactions
Medication

About Valsartan and Sacubitril

What Is Valsartan and Sacubitril Used For?

Brand name: Entresto

Sacubitril and valsartan is used to reduce the risk of cardiovascular death and hospitalization for heart failure in adult patients with chronic heart failure. The benefit is most clearly seen in patients whose heart pumps with a lower-than-normal ejection fraction (the percentage of blood the heart pushes out with each beat).

It is also approved to treat symptomatic heart failure with reduced left ventricular function in children aged 1 year and older. In pediatric patients, it lowers a blood marker of heart stress (NT-proBNP) and is expected to improve heart outcomes.

See full Valsartan and Sacubitril drug information
Keep checking

Other Drugs & Equol

Browse every other medication we’ve checked against Equol — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
58Moderate
74Minor
2,697No known interaction
58 Moderate 74 Minor 2,697 No interaction
Moderate

58 interactions

Minor

74 interactions

Showing 60 of 74 minor interactions — see all 74 on the Equol page.

No interaction 2,697 drugs checked — show the list

We also checked Equol against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,697 medications checked with no known interaction — see the full Equol list.

See the full Equol interactions page
See every supplement checked against Sacubitril, Valsartan, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

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

Keep exploring
Equol monograph › Uses, safety, and every drug interaction in one place Sacubitril, Valsartan supplement interactions › Every supplement checked against Sacubitril, Valsartan, ranked by severity Valsartan and Sacubitril drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Equol and Sacubitril, Valsartan Together: Common Questions

Can you take Equol with Sacubitril, Valsartan?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Equol and Sacubitril, Valsartan interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Sacubitril, Valsartan and Equol?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.