epleronone (Inspra)

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Indications

* improves mortality in patients after myocardial infarction with heart failure & left ventricular ejection fraction < 40% (11.85 vs 13.6%, 12.5% vs 15.5%[6][7][8])

Contraindications

pregnancy category = b

Dosage

* Doses > 100 mg associated with increased risk of hyperkalemia without additional clinical benefit

Pharmacokinetics

Tabs: 25, 50 mg.

Monitor

Adverse effects

Drug interactions

Mechanism of action

Notes

cost $99/30 tabs, 2005

More general terms

References

  1. Prescriber's Letter 10(11):62 2003
  2. Journal Watch 23(9):72, 2003 Pitt B et al, N Engl J Med 348(Apr 3):1309, 2003 http://content.nejm.org/cgi/content/abstract/348/14/1309 Jessup M, N Engl J Med 348(14):1380, 2003 http://content.nejm.org/cgi/content/abstract/348/14/1380
  3. LexiComp, Drug Information, 2005
  4. 4.0 4.1 4.2 Prescriber's Letter 17(7): 2010 Recommended Lab Monitoring for Common Medications Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=260704&pb=PRL (subscription needed) http://www.prescribersletter.com
  5. 5.0 5.1 Prescriber's Letter 17(8): 2010 COMMENTARY: Eplerenone (Inspra) for Mild Systolic Heart Failure GUIDELINES: Diagnosis and Management of Heart Failure in Adults (ACC/AHA, 2009 Update) Detail-Document#: http://prescribersletter.com/(5bhgn1a4ni4cyp2tvybwfh55)/pl/ArticleDD.aspx?li=1&st=1&cs=&s=PRL&pt=3&fpt=25&dd=260804&pb=PRL (subscription needed) http://www.prescribersletter.com
  6. 6.0 6.1 Zannad F et al. Eplerenone in patients with systolic heart failure and mild symptoms. N Engl J Med 2010 Nov 14; [e-pub ahead of print] <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/21073363 <Internet> http://dx.doi.org/10.1056/NEJMoa1009492
    Armstrong PW. Aldosterone antagonists - Last man standing? N Engl J Med 2010 Nov 14; [e-pub ahead of print] <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/21073364 <Internet> http://dx.doi.org/10.1056/NEJMe101254
  7. 7.0 7.1 Pitt B, Remme W, Zannad F et al Eplerenone, a selective aldosterone blocker, in patients with left ventricular dysfunction after myocardial infarction. N Engl J Med. 2003 Apr 3;348(14):1309-21. PMID: https://www.ncbi.nlm.nih.gov/pubmed/12668699
  8. 8.0 8.1 Medical Knowledge Self Assessment Program (MKSAP) 16, American College of Physicians, Philadelphia 2012

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