- Eplerenone and Spironolactone are Potassium-Sparing Diuretics (as are Triamterene and Amiloride)
- Eplerenone and Spironolactone are also both Selective Aldosterone Receptor Antagonists
- Eplerenone is more selective for Aldosterone than Spironolactone
- Serum Potassium >5.0 mEq/L
- Type II Diabetes Mellitus with Microalbuminuria
-
Renal Insufficiency
- Serum Creatinine >2.5 (GFR <30 ml/min)
- Anuria
-
Hypertension
- Start: 50 mg orally daily
- Decrease starting dose to 25 mg orally daily if using strong Cytochrome P450 3A4 inhibitor
- May increase to 50 mg orally twice daily after 4 weeks
- Start: 50 mg orally daily
-
Congestive Heart Failure
- Start: 25 mg orally daily for 4 weeks (then increase to target dose if tolerated)
- Target: 50 mg orally daily
- Increased Serum Potassium (Hyperkalemia risk)
- Potassium Supplementation
- NSAIDs
- ACE Inhibitor
- Trimethoprim-Sulfamethoxazole
-
Digoxin
- Increased Digoxin Toxicity risk via increased Digoxin half life
-
Norepinephrine
- Decreases NorepinephrineVasopressor activity
-
Cytochrome P450 3A4 inhibitors (e.g. Ketoconazole, Itraconazole)
- Significantly increases Eplerenone levels
- Limit max Eplerenone dose to 25 mg daily or twice daily if used with a strong CYP 3A4 inhibitor
- Pregnancy Category B
- Unknown Safety in Lactation
- Olson (2020) Clinical Pharmacology, Medmaster, Miami, p. 62-3
- Hamilton (2010) Tarason Pocket Pharmacopeia, p. 74
- (2003) Lexi-Comp Drug Database
- (2003) Med Lett Drugs Ther 45(1156):39-40 [PubMed]
- Stier (2003) Heart Dis 5(2):102-18 [PubMed]