Eplerenone
A relatively selective mineralo-corticoid receptor antagonist, blocking binding of aldosterone and reducing blood pressure.Congestive heart failure; post myocardial infarction, hypertension.
Dose adjustment based on serum potassium level (SPK). Taken orally with or without food. Congestive heart failure, and post myocardial infarction: adult : initial 25mg once a day slowly increase to recommended dose of 50mg once daily within 4-weeks as tolerated. Hypertension Adult : initially 50mg once a day which may be increased to 50mg twice a day based on response. If used concurrently with moderate CYP3A4 inhibitors initial dose 25mg once daily.
For all patients : serum potassium more than 5.5mEq/L at initiation. Crcl=30L/min.
Monitor serum potassium levels. Impaired renal functions; Diabetic patients with CHF/Post myocardial infarction/server hepatic impairments. Pediatric patients less than 18 years of age, pregnancy and lactation, eldrely.
Hyperkalaemia, hyponatraemia, hypercholesterolemia, hypertriglyceridaemia, albuminuria, increased creatinine, elevated liver enjymes, increased uricacid, rash, angioneurotic edema, abnormal vaginal bleeding, gynaecomastia, mastodynia, myocardial infarction, angina pectoris, dizziness, headache, abdonimal pain, diarrhea, fatigue, cough, influenza-like symptoms.
Concomitant use with CYP3A4 inhibitors may increased serum concentration of eplerenone while CYP3A4 inducers may decrease eplerenone efficacy. Eplerenone may enhance hyperkalamic effects of potassium sparing diuretics, potassium salts, ACE inhibitors or angiotensin II receptor blockers.
