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Drug Interactions between eplerenone and Garlix

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Minor

garlic eplerenone

Applies to: Garlix (garlic) and eplerenone

Garlic has been found in some studies to lower blood pressure and may theoretically potentiate the effects of hypotensive agents. A meta-analysis of 11 randomized, placebo-controlled studies showed a mean decrease of 4.6 mmHg for systolic blood pressure and no significant effect for diastolic blood pressure in subjects treated with garlic (most often garlic powder 600 to 900 mg/day, providing 3.6 to 5.4 mg of the active component allicin) compared to placebo. In the subgroup analysis of studies where subjects had a mean baseline blood pressure in the hypertensive range (SBP 140 mmHg or higher; DBP 90 mmHg or higher), mean decrease associated with garlic was 8.4 mmHg and 7.3 mmHg, respectively, for systolic and diastolic blood pressure. There have been no reports of clinical hypotension associated with concomitant use of garlic and antihypertensive agents.

References (2)
  1. Richard CL, Jurgens TM (2005) "Effects of natural health products on blood pressure." Ann Pharmacother, 39, p. 712-20
  2. Tattelman E (2005) "Health effects of garlic." Am Fam Physician, 72, p. 103-6

Drug and food interactions

Major

eplerenone food

Applies to: eplerenone

GENERALLY AVOID: Coadministration with grapefruit juice may increase the plasma concentrations of eplerenone. The primary mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruits. Inhibition of hepatic CYP450 3A4 may also contribute. In drug interaction studies, administration of a single 100 mg dose of eplerenone in combination with grapefruit juice resulted in a 25% increase in eplerenone systemic exposure (AUC). High blood levels of eplerenone can increase the risk of side effects including hyperkalemia. In general, the effect of grapefruit juice is concentration-, dose- and preparation-dependent, and can vary widely among brands. Certain preparations of grapefruit juice (e.g., high dose, double strength) have sometimes demonstrated potent inhibition of CYP450 3A4, while other preparations (e.g., low dose, single strength) have typically demonstrated moderate inhibition.

MANAGEMENT: It may be advisable for patients to avoid the consumption of grapefruit, grapefruit juice, or supplements that contain grapefruit during treatment with eplerenone.

References (3)
  1. (2002) "Product Information. Inspra (eplerenone)." Searle
  2. (2021) "Product Information. Eplerenone (eplerenone)." MSN Laboratories Europe Ltd
  3. (2023) "Product Information. Eplerenone (Apotex) (eplerenone)." Apotex Pty Ltd

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
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.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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