Generic Name: Eplerenone Brand Name(s): Eplerenone.

Uses

What is Eplerenone used for?

Eplerenone is commonly used alone or in combination with other medicines to treat high blood pressure. It works by blocking a chemical (aldosterone) in your body which in turn lowers the amount of sodium and water the body retains. Lowering high blood pressure helps prevent strokes, heart attacks and kidney problems. It is also used to treat congestive heart failure following a heart attack.

How should I take Eplerenone?

Take this medication by mouth, usually once or twice daily, with or without food, or as directed by your doctor. Use this medication regularly in order to get the most benefit from it. Remember to use it at the same time(s) each day.

The dosage is based on your medical condition (high blood pressure, heart failure), response to treatment, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

It may take up to 4 weeks for this medication to fully affect your blood pressure.

It is important to continue taking this medication even if you feel well. Most people with high blood pressure do not feel sick.

How do I store Eplerenone?

Eplerenone is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Eplerenone in the bathroom or the freezer. There may be different brands of Eplerenone that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Eplerenone down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Eplerenone?

Before taking eplerenone, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: high potassium blood levels (hyperkalemia), kidney disease, diabetes.

This medication may increase your potassium levels. Before using potassium supplements or salt substitutes that contain potassium, consult your doctor or pharmacist.

This drug may make you dizzy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely. Limit alcoholic beverages.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Older adults may be more sensitive to the effects of this drug, especially the raising of potassium blood levels.

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding.

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Eplerenone during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking this Eplerenone. This Eplerenone is pregnancy risk category B according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Eplerenone?

Headache, dizziness, diarrhea, or vomiting may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: abnormal vaginal bleeding, enlarged or sore breasts in males, symptoms of a high potassium blood level (such as muscle weakness, slow/irregular heartbeat).

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Eplerenone?

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

Some of the products that may interact with this drug include: drugs that may increase the level of potassium in the blood (such as birth control pills containing drospirenone, potassium sparing “water pills” such as amiloride/spironolactone/triamterene), lithium.

Other medications can affect the removal of eplerenone from your body, which may affect how eplerenone works. Examples include certain azole antifungals (such as ketoconazole, itraconazole), boceprevir, clarithromycin, cobicistat, nefazodone, certain HIV protease inhibitors (such as nelfinavir, ritonavir), St. John’s wort, telaprevir, telithromycin, among others.

Some products have ingredients that could raise your blood pressure or worsen your heart failure. Tell your pharmacist what products you are using, and ask how to use them safely (especially cough-and-cold products, diet aids, or NSAIDs such as ibuprofen/naproxen).

Eplerenone may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Eplerenone?

Eplerenone may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Eplerenone?

Eplerenone may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Eplerenone.

What is the dose of Eplerenone for an adult?

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.

Renal Dose Adjustments

Eplerenone is contraindicated in patients with a creatinine clearance less than or equal to 30 mL/min. Eplerenone is also contraindicated in the treatment of hypertension in patients who have a serum creatinine greater than 2.0 mg/dL (males) or greater than 1.8 mg/dL (females), and in those with a creatinine clearance less than 50 mL/min.

Liver Dose Adjustments

No dosage adjustment is necessary for patients with mild-to-moderate hepatic impairment. The use of eplerenone has not been evaluated in patients with severe hepatic impairment.

Dose Adjustments

Hypertension: For patient receiving weak CYP450 3A4 inhibiting drugs, such as erythromycin, saquinavir, verapamil, and fluconazole, the starting dose should be reduced to 25 mg once daily.

Congestive heart failure post-myocardial infarction–Dose adjustments based on serum potassium level:

Less than 5 mEq/L: Increase dosage from 25 mg every other day to 25 mg daily or from 25 mg daily to 50 mg daily

5 to 5.4 mEq/L: No adjustment recommended

5.5 to 5.9 mEq/L: Decrease dosage from 50 mg daily to 25 mg daily or from 25 mg daily to 25 mg every other day or from 25 mg every other day to withhold

6 mEq/L or higher: Withhold

Dialysis

Eplerenone is not removed by hemodialysis.

Other Comments

In patients with congestive heart failure as a result of acute MI, evidence suggests that initiating eplerenone within 3 to 7 days post-MI is associated with a greater reduction in mortality and hospitalizations than late (i.e., 8 to 14 days post-MI) administration.

What is the dose of Eplerenone for a child?

The dosage has not been established in pediatric patients. It may be unsafe for your child. It is always important to fully understand the safety of the drug before using. Please consult with your doctor or pharmacist for more information.

How is Eplerenone available?

Eplerenone is available in the following dosage forms and strengths:

  • Tablet

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Eplerenone, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: January 25, 2018 | Last Modified: January 25, 2018

Want to live your best life?
Get the Hello Doktor Daily newsletter for health tips, wellness updates and more.