eplerenone

Generic Name: eplerenone (ep LER e none)
Brand Name: Inspra

What is eplerenone?

Eplerenone blocks the actions of the hormone aldosterone in the body. Aldosterone is important for the regulation of blood pressure.

Eplerenone is used to treat congestive heart failure after a heart attack. Eplerenone is also used to treat high blood pressure (hypertension).

Eplerenone may also be used for purposes not listed in this medication guide.

What is the most important information I should know about eplerenone?

You may not be able to take this medication if you have severe kidney disease, high potassium levels in your blood, or type 2 diabetes with protein in your urine.

You also may not be able to take eplerenone if you are also taking ketoconazole (Nizoral), itraconazole (Sporanox), nefazodone, clarithromycin (Biaxin), nelfinavir (Viracept), ritonavir (Norvir, Kaletra), or troleandomycin (Tao).

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Before taking eplerenone, tell your doctor if you have kidney or liver disease, high cholesterol, or high triglycerides.

Do not use salt substitutes or potassium supplements while taking eplerenone, unless your doctor has told you to.

To be sure this medication is helping your condition and is not causing harmful effects, your blood pressure will need to be checked on a regular basis. Your potassium levels will also need to be checked with frequent blood tests. Visit your doctor regularly.

If you are being treated for high blood pressure, keep using this medication even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medication for the rest of your life.

What should I discuss with my healthcare provider before taking eplerenone?

You may not be able to take this medication if you are allergic to eplerenone, or if you have:

• high potassium levels in your blood (hyperkalemia);

• severe kidney disease;

• type 2 diabetes with protein in your urine; or

• if you are also taking ketoconazole (Nizoral), itraconazole (Sporanox), nefazodone, clarithromycin (Biaxin), nelfinavir (Viracept), ritonavir (Norvir, Kaletra), or troleandomycin (Tao).

To make sure you can safely take eplerenone, tell your doctor if you have any of these other conditions:

• kidney disease;

• liver disease; or

• high cholesterol or triglycerides;

FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

It is not known whether eplerenone passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take eplerenone?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Your doctor may occasionally change your dose to make sure you get the best results.

Eplerenone may be taken with or without food.

To be sure this medication is helping your condition and is not causing harmful effects, your blood pressure will need to be checked on a regular basis. Your potassium levels will also need to be checked with frequent blood tests. Visit your doctor regularly.

If you are being treated for high blood pressure, keep using this medication even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medication for the rest of your life.

Store at room temperature away from moisture and heat.

See also: Eplerenone dosage (in more detail)

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include slow heart rate, weak pulse, muscle weakness, dizziness, or feeling like you might pass out.

What should I avoid while taking eplerenone?

Do not use salt substitutes or potassium supplements while taking eplerenone, unless your doctor has told you to.

This drug side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; severe stomach pain; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have a serious side effect such as:

• high potassium (slow heart rate, weak pulse, muscle weakness, tingly feeling); or

• low potassium (confusion, uneven heart rate, extreme thirst, increased urination, leg discomfort, muscle weakness or limp feeling).

Less serious side effects may include:

• diarrhea, stomach pain;

• cough;

• dizziness;

• tired feeling;

• fever, chills, body aches, flu symptoms;

• vaginal bleeding; or

• breast swelling or tenderness.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: eplerenone side effects (in more detail)

Eplerenone Dosing Information

Usual Adult Dose for Congestive Heart Failure:

Congestive heart failure post-myocardial infarction:
Initial dosage: 25 mg orally once daily. Dosage should titrated to the target dose of 50 mg once daily preferably within 4 weeks.

Usual Adult Dose for Hypertension:

50 mg orally once daily. Patients with an inadequate blood pressure response should be increased to 50 mg twice a day.

What other drugs will affect eplerenone?

Many drugs can interact with eplerenone. Below is just a partial list. Tell your doctor if you are using:

• lithium (Lithobid, Eskalith, others);

• other blood pressure medications such as candesartan (Atacand), eprosartan (Teveten), irbesartan (Avapro), losartan (Cozaar), olmesartan (Benicar), telmisartan (Micardis), or valsartan (Diovan);

• an antibiotic such as clarithromycin (Biaxin) or erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin, Pediazole);

• an antifungal medication such as fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral);

• an ACE inhibitor such as benazepril (Lotensin), captopril (Capoten), fosinopril (Monopril), enalapril (Vasotec), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), or trandolapril (Mavik);

• an NSAID (non-steroidal anti-inflammatory drugs) such as ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn, Naprelan, Treximet), celecoxib (Celebrex), diclofenac (Arthrotec, Cambia, Cataflam, Voltaren, Flector Patch, Pennsaid, Solareze), indomethacin (Indocin), meloxicam (Mobic), and others;

• HIV/AIDS medicine such as nelfinavir (Viracept) or ritonavir (Norvir, Kaletra);

• an "SSRI" antidepressant such as fluoxetine (Prozac), fluvoxamine (Luvox), or paroxetine (Paxil); or

• an antidepressant such as amitriptyline (Elavil, Vanatrip, Limbitrol), doxepin (Sinequan, Silenor), nortriptyline (Pamelor), and others.

This list is not complete and other drugs may interact with eplerenone. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

• Your pharmacist can provide more information about eplerenone.