Eplerenone (Eplerenone)
Overview of Eplerenone
Eplerenone, a blocker of aldosterone binding at the mineralocorticoid receptor. It is chemically described as Pregn-4-ene-7,21-dicarboxylic acid, 9,11-epoxy-17-hydroxy-3-oxo-,gama -lactone, methyl ester, (7alpha,11alpha,17alpha). Its empirical formula is C24H30O6.
Indication of Eplerenone
Eplerenone is primarily indicated in conditions like Hypertension, and can also be given in adjunctive therapy as an alternative drug of choice in Congestive heart failure post MI, Left ventricular dysfunction.
Contraindication of Eplerenone
Eplerenone is contraindicated in conditions like Hyperkalaemia,Severe renal impairment.
Side Effects of Eplerenone
The severe or irreversible adverse effects of Eplerenone, which give rise to further complications include Angioneurotic edema, Albuminuria, Vaginal bleeding, Gynecomastia.,Eplerenone produces potentially life-threatening effects which include Myocardial infarction, Anaphylactic reactions, Shortness of breath. which are responsible for the discontinuation of Eplerenone therapy.,The signs and symptoms that are produced after the acute overdosage of Eplerenone include Hypotension, Hyperkalemia.,The symptomatic adverse reactions produced by Eplerenone are more or less tolerable and if they become severe, they can be treated symptomatically, these include Dizziness, Nausea, Vomiting, Diarrhea, Hypotension, Cough, Light headedness, Faintness.
Precautions of Eplerenone
Monitor patients for the development of hyperkalemia until the effect of eplerenone is established. Patients who develop hyperkalemia ( > 5.5 mEq/L) may continue eplerenone therapy with proper dose adjustment. Dose reduction decreases potassium levels. Patients with hypertension who have serum creatinine levels > 2.0 mg/dL (males) or > 1.8 mg/dL (females) or creatinine clearance = 50 mL/min should not be treated with it. Patients with CHF post-MI who have serum creatinine levels > 2.0 mg/dL (males) or > 1.8 mg/dL (females) or creatinine clearance = 50mL/min should be treated with eplerenone with caution. Diabetic patients with CHF post-MI should also be treated with caution, especially those with proteinuria. Safety and efficacy not established in patients with severe hepatic impairment; or paediatric patients <18 yr. Pregnancy and lactation.