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| __NOTOC__
| | #REDIRECT [[Eplerenone#Drug Interactions]] |
| {{Eplerenone}}
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| {{CMG}}; {{AE}} {{SS}}
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| ==Drug Interactions==
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| ===7.1 CYP3A4 Inhibitors===
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| Because eplerenone metabolism is predominantly mediated via CYP3A4, do not use INSPRA with drugs that are strong inhibitors of CYP3A4. [SeeCONTRAINDICATIONS (4) and CLINICAL PHARMACOLOGY (12.3).]
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| In patients with hypertension taking moderate CYP3A4 inhibitors, reduce the starting dose of INSPRA to 25 mg once daily. [See DOSAGE AND ADMINISTRATION (2.3, 2.4) and CLINICAL PHARMACOLOGY (12.3).]
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| ===7.2 ACE Inhibitors and Angiotensin II Receptor Antagonists===
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| The risk of [[hyperkalaemia]] may increase when eplerenone is used in combination with an [[angiotensin converting enzyme]] (ACE) inhibitor and/or an [[angiotensin receptor blocker]] (ARB). A close monitoring of serum potassium and renal function is recommended, especially in patients at risk for impaired renal function, e.g., the elderly. [seeWARNINGS AND PRECAUTIONS (5.1)]
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| ====Congestive Heart Failure Post-Myocardial Infarction====
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| In EPHESUS [see CLINICAL STUDIES (14.1)], 3020 (91%) patients receiving INSPRA 25 to 50 mg also received ACE inhibitors or angiotensin II receptor antagonists (ACEI/ARB). Rates of patients with maximum potassium levels >5.5 mEq/L were similar regardless of the use of ACEI/ARB.
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| ====Hypertension====
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| In clinical studies of patients with [[hypertension]], the addition of INSPRA 50 to 100 mg to ACE inhibitors and angiotensin II receptor antagonists increased mean serum potassium slightly (about 0.09–0.13 mEq/L). In a study in diabetics with microalbuminuria, INSPRA 200 mg combined with the ACE inhibitor enalapril 10 mg increased the frequency of [[hyperkalemia]] (serum potassium >5.5 mEq/L) from 17% on enalapril alone to 38%.
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| ===7.3 Lithium===
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| A drug interaction study of eplerenone with [[lithium]]has not been conducted. [[lithium]]toxicity has been reported in patients receiving [[lithium]]concomitantly with diuretics and ACE inhibitors. Serum [[lithium]]levels should be monitored frequently if INSPRA is administered concomitantly with lithium.
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| ===7.4 Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)===
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| A drug interaction study of eplerenone with an NSAID has not been conducted. The administration of other potassium-sparing antihypertensives with [[NSAIDs]] has been shown to reduce the antihypertensive effect in some patients and result in severe [[hyperkalemia]] in patients with impaired renal function. Therefore, when INSPRA and [[NSAIDs]] are used concomitantly, patients should be observed to determine whether the desired effect on blood pressure is obtained and monitored for changes in serum potassium levels.<ref name="dailymed.nlm.nih.gov">{{Cite web | last = | first = | title = INSPRA (EPLERENONE) TABLET, FILM COATED [G.D. SEARLE LLC DIVISION OF PFIZER INC] | url = http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=a55a39ff-1bd5-428b-a64f-c44262e2f3ed | publisher = | date = | accessdate = 28 February 2014 }}</ref>
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| ==References==
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| {{Reflist}}
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| [[Category:Aldosterone antagonists]]
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| [[Category:Pfizer]]
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| [[Category:Lactones]]
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| [[Category:Epoxides]]
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| [[Category:Cardiovascular Drugs]]
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| [[Category:Drugs]]
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