aldosterone receptor antagonist (aldosterone antagonist)
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Indications
- heart failure, myocardial infarction
- mortality benefit after STEMI with or without heart failure[4]
- LVEF < 40% after NSTEMI
- renal disease
- hyperaldosteronism[2]
- hypertension
- edema, including peripheral edema, ascites, pulmonary edema
- cirrhosis
- polycystic ovary syndrome
- hypokalemia[2]
Adverse effects
- hyperkalemia
- little effect on blood pressure[6]
- drug adverse effects of renin-angiotensin-aldosterone system inhibitors (RAAS inhibitors)
- drug adverse effects of antihypertensive agents
Drug interactions
- coadministration of ACE inhibitor or ARB with aldosterone antagonist associated with risk of hyperkalemia
- risk for severe hyperkalemia is lower with coadministration of sacubitril/valsartan than with enalapril[3]
- drug interaction(s) of calcineurin inhibitors with ACE inhibitors
- drug interaction(s) of calcineurin inhibitors with ARBs
- drug interaction(s) of renin-angiotensin-aldosterone inhibitors with trimethoprim-sulfamethoxazole
- drug interaction(s) of aldosterone antagonists with SGLT2-inhibitor
- drug interaction(s) of NSAIDs with aldosterone antagonis
- drug interaction(s) of NSAIDs & antihypertensives
More general terms
More specific terms
Additional terms
- K+ sparing diuretic
- mineralocorticoid receptor; MR; nuclear receptor subfamily 3 group C member 2 (NR3C2, MCR, MLR)
References
- ↑ Rossing K et al. Beneficial effects of adding spironolactone to recommended antihypertensive treatment in diabetic nephropathy. A randomized, double-masked, cross-over study. Diabetes Care 2005 Sep; 28:2106-12. PMID: https://www.ncbi.nlm.nih.gov/pubmed/16123474
- ↑ 2.0 2.1 2.2 Deprecated Reference
- ↑ 3.0 3.1 Desai AS, Vardeny O, Claggett B et al Reduced Risk of Hyperkalemia During Treatment of Heart Failure With Mineralocorticoid Receptor Antagonists by Use of Sacubitril/ Valsartan Compared With Enalapril. A Secondary Analysis of the PARADIGM-HF Trial. JAMA Cardiol. Published online November 14, 2016 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27842179 <Internet> http://jamanetwork.com/journals/jamacardiology/article-abstract/2583456
Ezekowitz JA Hyperkalemia, Sacubitril/Valsartan, and Mineralocorticoid Antagonists in Patients With Heart Failure. JAMA Cardiol. Published online November 14, 2016 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/27842180 <Internet> http://jamanetwork.com/journals/jamacardiology/article-abstract/2583455 - ↑ 4.0 4.1 Dahal K, Hendrani A, Sharma SP et al Aldosterone Antagonist Therapy and Mortality in Patients With ST-Segment Elevation Myocardial Infarction Without Heart Failure. A Systematic Review and Meta-analysis. JAMA Intern Med. Published online May 21, 2018 PMID: https://www.ncbi.nlm.nih.gov/pubmed/29799995 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2681656
Pitt B, Zannad F. Mineralocorticoid Receptor Antagonists in ST-Segment Elevation Myocardial Infarction JAMA Intern Med. Published online May 21, 2018 PMID: https://www.ncbi.nlm.nih.gov/pubmed/29799990 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2681651 - ↑ NEJM Knowledge+
- ↑ 6.0 6.1 Writing Committee; Hollenberg SM, Stevenson LW, Ahmad T et al 2024 ACC Expert Consensus Decision Pathway on Clinical Assessment, Management, and Trajectory of Patients Hospitalized With Heart Failure Focused Update: A Report of the American College of Cardiology Solution Set Oversight Committee J Am Coll Cardiol. 2024 Aug 2:S0735-1097(24)07449-7. PMID: https://www.ncbi.nlm.nih.gov/pubmed/39127954 https://www.jacc.org/doi/10.1016/j.jacc.2024.06.002