Inspra的注意事项有什么？

It has definite efficacy in the treatment of hypertension, heart failure and myocardial infarction, has fewer adverse reactions and is well tolerated. So, what are the precautions for using Inspra?

1. Diabetes: Use with caution in patients with diabetes and heart failure after myocardial infarction (especially those with proteinuria); the risk of hyperkalemia is increased. 

2. Heart failure: Instruct patients with heart failure to discontinue use during episodes of diarrhea or dehydration or when circulating diuretic therapy is interrupted. 

3. Liver damage: Use with caution in patients with moderate to severe liver damage. 

4. Kidney damage: As kidney function declines, the risk of hyperkalemia increases. Use with caution in patients with mild renal impairment; it may be disabled depending on the indications and degree of damage. 

5. Potassium supplements: Avoid potassium supplements, potassium-containing salt substitutes, potassium-rich diets, or other drugs that may cause hyperkalemia (such as other potassium-sparing diuretics, nonsteroidal anti-inflammatory drugs). Concomitant use of potassium supplements or potassium-sparing diuretics is contraindicated in the treatment of hypertension. 

6. Pregnancy: Untreated high blood pressure and heart failure are both associated with adverse pregnancy outcomes. The use of mineralocorticoid receptor antagonists is not recommended for the treatment of chronic isolated hypertension in pregnant women and should generally be avoided in women of reproductive potential.

7. Drug-Drug Interactions: Significant interactions may exist requiring dose or frequency adjustment, additional monitoring, and/or the selection of alternative therapies. 

8. Hyperkalemia: Hyperkalemia may occur; the risk of hyperkalemia increases with renal impairment, proteinuria, diabetes, and patients taking concurrent ACE (angiotensin-converting enzyme) inhibitors, angiotensin II inhibitors, nonsteroidal anti-inflammatory drugs, or moderate CYP3A inhibitors. Monitor closely for hyperkalemia; serum potassium increased dose-related during clinical trials. As hyperkalemia develops, dose reduction or treatment interruption may be necessary. If concomitant treatment with moderate CYP3A4 inhibitors cannot be avoided, reduce dose. It is contraindicated in patients with potassium greater than 5.5 meq/L at the beginning of treatment.