Eplerenone

To treat heart failure or prevent heart failure after a heart attack, the recommended starting dose is 25 mg given once daily. It is usually increased by your doctor to 50 mg once daily, within 4 weeks. Eplerenone is usually started within 2 weeks of a heart attack.

For treating high blood pressure, the starting dose of eplerenone is 50 mg taken once daily. If your blood pressure has not come down enough after 4 weeks, your doctor may increase the dose of eplerenone to 50 mg taken two times a day.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

Eplerenone can be taken with or without food. Swallow the tablets with water and without chewing.

It is important that Eplerenone be taken exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose for to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Eplerenone at room temperature and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

In addition to its desired action, this medication may cause some adverse effects, notably: it may cause dizziness - use caution when getting up from a lying or sitting position and use caution if driving; it may cause an increase of potassium in your blood. Periodic blood collection may be needed to evaluate its actual effect.. Each person may react differently to a treatment. If you think this medication may be causing adverse effects (including those described here, or others), talk to your health care professional. He or she can help you to determine whether or not the medication is the source of the problem.

25 mg
Each yellowish red, diamond-shaped, biconvex, film-coated tablet, debossed with "E" on one side and "25" on the other contains 25 mg of eplerenone. Nonmedicinal ingredients: croscarmellose sodium, D&C Yellow No. 10 Aluminium Lake, FD&C Yellow No. 6 Aluminum Lake, hydroxypropyl methylcellulose, iron oxide red, iron oxide yellow, lactose monohydrate, polyethylene glycol, magnesium stearate, microcrystalline cellulose, polysorbate 80, sodium lauryl sulfate, talc, and titanium dioxide.

50 mg
Each yellowish red, diamond shaped, biconvex, film-coated tablet, debossed with "E" on one side and "50" on the other contains 50 mg of eplerenone. Nonmedicinal ingredients: croscarmellose sodium, D&C Yellow No. 10 Aluminium Lake, FD&C Yellow No. 6 Aluminum Lake, hydroxypropyl methylcellulose, iron oxide red, iron oxide yellow, lactose monohydrate, polyethylene glycol, magnesium stearate, microcrystalline cellulose, polysorbate 80, sodium lauryl sulfate, talc, and titanium dioxide.

Do not take eplerenone if you:

• are allergic to eplerenone or any ingredients of the medication
• are taking other medications that may affect how the body gets rid of eplerenone (e.g., ketoconazole, itraconazole, nefazodone, telithromycin, clarithromycin, ritonavir, nelfinavir)
• are taking potassium supplements or potassium-sparing diuretics (e.g., Spironolactone)
• have high levels of potassium in your blood
• have severe kidney dysfunction
• have severe liver dysfunction

In addition, if you are taking Eplerenone for high blood pressure, do not take eplerenone if you:

• have Type 2 Diabetes with protein in the urine
• have moderate-to-severe kidney dysfunction
• have high levels of creatinine in your blood

There may be an interaction between eplerenone and any of the following:

• Abiraterone
• Aldesleukin
• Aliskiren
• alpha-agonists (e.g., Clonidine, methyldopa)
• alpha-blockers (e.g., Alfuzosin, Doxazosin, Tamsulosin)
• amifostine
• Amiodarone
• amphetamines (e.g., Dextroamphetamine, Lisdexamfetamine)
• angiotensin converting enzyme inhibitors (ACEIs; e.g., Captopril, Lisinopril, Ramipril)
• angiotensin receptor blockers (ARBs; e.g., Candesartan, Irbesartan, Losartan)
• anti-psychotics (e.g., Clozapine, Olanzapine, Quetiapine, Risperidone)
• Apalutamide
• Aprepitant
• "azole" antifungals (e.g., itraconazole, ketoconazole, Voriconazole)
• barbiturates (e.g., butalbital, Phenobarbital)
• beta-adrenergic blockers (e.g., Atenolol, Propranolol, Sotalol)
• Bicalutamide
• Bosentan
• brimonidine
• calcium channel blockers (e.g., Diltiazem, Verapamil)
• Carbamazepine
• conivaptan
• Cyclosporine
• Deferasirox
• Desipramine
• dexmethylphenidate
• Digoxin
• diuretics (water pills; e.g., Furosemide, Hydrochlorothiazide, triamterene)
• Dronedarone
• drospirenone
• Duloxetine
• Enzalutamide
• Guanfacine
• grapefruit juice
• Heparin
• Hepatitis C antivirals (e.g., dasabuvir, ombitasvir, paritaprevir)
• HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs; e.g., efavirenz, etravirine, nevirapine)
• HIV protease inhibitors (e.g., atazanavir, indinavir, ritonavir, saquinavir)
• levodopa
• lithium
• Lomitapide
• low molecular weight heparins (e.g., Dalteparin, Enoxaparin, Tinzaparin)
• macrolide antibiotics (e.g., clarithromycin, erythromycin)
• Methylphenidate
• mifepristone
• Mitotane
• Modafinil
• monoamine oxidase inhibitors (M.O.S. e.g., Moclobemide, Phenelzine, Rasagiline, Selegiline, Tranylcypromine)
• narcotic pain relievers (e.g., Codeine, Fentanyl, Morphine, Oxycodone)
• nitrates (e.g., Nitroglycerin, isosorbide dinitrate, isosorbide mononitrate)
• Nitrofurantoin
• nonsteroidal anti-inflammatory drugs (NSAIDs; e.g. Diclofenac, Ibuprofen, Ketorolac, Naproxen)
• Obinutuzumab
• Oxcarbazepine
• Pentoxifylline
• Phenytoin
• phosphodiesterase 5 inhibitors (e.g., Sildenafil, Tadalafil, Vardenafil)
• potassium supplements or salt substitutes containing potassium
• primidone
• protein kinase inhibitors (e.g., Crizotinib, Dabrafenib, Dasatinib, imatinib)
• quinidine
• rifabutin
• rifampin
• Rituximab
• St. John's wort
• Sarilumab
• Sertraline
• siltuximab
• sodium phosphates
• Tacrolimus
• Tocilizumab
• Tolvaptan
• Trimethoprim
• Yohimbine

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Eplerenone. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Eplerenone.

Diabetes: People with diabetes that have heart failure after a heart attack, especially those who have proteinuria (protein in the urine), appear to have a higher rate of hyperkalemia (high blood potassium; see below). If you have diabetes, discuss with your doctor how Eplerenone may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Eplerenone, and whether any special monitoring is needed.

Kidney problems: The safety of eplerenone when used to treat people with moderate-to-severe kidney dysfunction has not been determined. These people should not take eplerenone.

If you have reduced kidney function or Kidney Disease, discuss with your doctor how Eplerenone may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Eplerenone, and whether any special monitoring is needed.

Liver function: Liver disease or reduced liver function may cause Eplerenone to build up in the body, causing side effects.

If you have liver problems, discuss with your doctor how Eplerenone may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Eplerenone, and whether any special monitoring is needed.

The safety of eplerenone when used to treat people with severe liver dysfunction has not been determined. These people should not take eplerenone.

Potassium levels: Too much potassium in the blood (hyperkalemia) is one of the most common risks of eplerenone. Hyperkalemia that is not recognized and treated can cause serious heart rhythm problems, which can sometimes be fatal. Your doctor will monitor your potassium levels before starting eplerenone, during the first week of taking eplerenone, and periodically throughout your therapy.

Do not take potassium supplements (including dietary potassium) or salt substitutes at the same time as eplerenone unless directed to do so by your doctor. If you experience an irregular, slow, or weak heartbeat, contact your doctor as soon as possible.

Pregnancy: Eplerenone should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking Eplerenone, contact your doctor immediately.

Breast-feeding: It is not known if eplerenone passes into breast milk. If you are a breast-feeding mother and are taking Eplerenone, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using Eplerenone have not been established for children. Eplerenone is not recommended for children.

Seniors: People over the age of 65 may be at increased risk of experiencing side effects from this mediation as a result of decreased kidney function. Doses for seniors may start lower and increase more slowly than for other adults.

This medication is typically used only once a day. However, your pharmacist may have suggested a different schedule that is more appropriate for you. Take it regularly and continuously to maintain its beneficial effects. Important: Follow the instructions on the label. Do not use more of this product, or more often, than prescribed. If you forget a dose, take it as soon as you remember -- unless it is almost time for your next dose. In that case, skip the missed dose. Do not double the next dose to catch up. This medication may be taken with or without food. Avoid all salt substitutes.