Drug interactions between Inspra and lisinopril
| Results for the following 2 drugs: |
|---|
| Inspra (eplerenone) |
| lisinopril |
Interactions between your selected drugs
lisinopril ↔ eplerenone
Applies to:lisinopril and Inspra (eplerenone)
MONITOR: Coadministration of eplerenone with ACE inhibitors or angiotensin II receptor antagonists may increase the risk of hyperkalemia due to additive pharmacodynamic effects. In clinical studies of patients with hypertension, the addition of eplerenone 50 to 100 mg to ACE inhibitors and angiotensin II receptor antagonists increased mean serum potassium slightly, by about 0.09 to 0.13 mEq/L. However, the concomitant use of another mineralocorticoid receptor blocker with these agents has led to clinically relevant hyperkalemia. In a study of diabetics with microalbuminuria, the combination of eplerenone 200 mg and enalapril 10 mg resulted in increased frequency of hyperkalemia (i.e., serum potassium greater than 5.5 mEq/L) compared to enalapril alone (38% vs. 17%). In a study of eplerenone 25 to 50 mg for the treatment of congestive heart failure postmyocardial infarction, maximum potassium levels exceeding 5.5 mEq/L were observed at a similar rate in the 90% of patients who also received ACE inhibitors or angiotensin II receptor antagonists compared to the patients who didn't.
MANAGEMENT: Given the potential for serious, sometimes fatal cardiac arrhythmias associated with hyperkalemia, caution is advised if eplerenone is administered with ACE inhibitors or angiotensin II receptor antagonists. Periodic monitoring of serum potassium levels is recommended until the effect of eplerenone is established. In clinical trials, monitoring occurred every 2 weeks for the first 1 to 2 months, then monthly thereafter. Particular caution is warranted in patients with renal impairment, diabetes, old age, or dehydration. Patients should be advised to seek medical attention if they experience signs and symptoms of hyperkalemia such as nausea, vomiting, weakness, listlessness, tingling of the extremities, paralysis, confusion, weak pulse, and a slow or irregular heartbeat.
See also...
Drug Interaction Classification
The classifications below are a guideline only. The relevance of a particular drug interaction to a specific patient is difficult to determine using this tool alone given the large number of variables that may apply.
| Major | Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. |
| Moderate | Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. |
| Minor | Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. |
Do not stop taking any medications without consulting your healthcare provider.
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