Drug Interaction Report

Consumer information for this interaction is not currently available.

MONITOR: Concomitant use of vamorolone and mineralocorticoid receptor antagonists may increase the risk of hyperkalemia. Inhibition of the mineralocorticoid receptor results in decreased aldosterone secretion which can lead to increases in serum potassium. Vamorolone has mineralocorticoid receptor antagonist activity which may be additive with that induced by mineralocorticoid receptor antagonists. Hyperkalemia has not been observed with vamorolone alone or in combination with eplerenone or spironolactone. Clinical data is not available.

MANAGEMENT: Some authorities advise caution if vamorolone is used with mineralocorticoid receptor antagonists, particularly in patients with renal impairment, diabetes, old age, worsening heart failure, and/or a risk for dehydration. Serum potassium should be checked one month after beginning combination therapy with vamorolone and a mineralocorticoid receptor antagonist. Patients should be advised to seek medical attention if they experience signs and symptoms of hyperkalemia such as weakness, listlessness, confusion, tingling of the extremities, and irregular heartbeat. If hyperkalemia occurs, a mineralocorticoid receptor antagonist dose reduction should be considered.

Consumption of grapefruit, grapefruit juice, and supplements that contain grapefruit should be avoided during treatment with eplerenone as they may increase the blood levels and effects of eplerenone. High blood levels of eplerenone can increase the risk of side effects including hyperkalemia (high blood potassium), which in severe cases can lead to kidney failure, muscle paralysis, irregular heart rhythm, and cardiac arrest. You may be more likely to develop hyperkalemia during treatment with eplerenone if you are elderly, dehydrated, or have kidney disease, diabetes, or advanced heart failure. You should seek medical attention if you experience nausea, vomiting, weakness, confusion, tingling of the hands and feet, feelings of heaviness in the legs, a weak pulse, or a slow or irregular heartbeat, as these may be symptoms of hyperkalemia. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Grapefruit juice may increase the blood levels and effects of vamorolone. This may increase the risk and/or severity of side effects such as swelling, weight gain, electrolyte abnormalities, high blood pressure, high blood glucose, muscle weakness, depression, mood swings, acne, thinning skin, stretch marks, easy bruising, cataracts, glaucoma, excessive growth of facial or body hair, and abnormal distribution of body fat, especially in the face, neck, back, and waist. Other side effects that may occur include decreased ability to fight infections, increased risk of developing infections, and inadequate response to stress such as infection, surgery, trauma, or a severe asthma attack. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.