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(eplerenone) was developed by Pfizer of the United States and was first launched in the United States in 2002. It is mainly used clinically to treat hypertension. In 2003, it was approved by the FDA for the treatment of heart failure after acute myocardial infarction. Eplerenone is a new type of selective aldosterone receptor antagonist.

Studies have shown that eplerenone can cause a sustained increase in plasma renin and serum aldosterone, and at the same time block the feedback regulatory effect of aldosterone. However, the increase in plasma renin activity and the increase in systemic circulation aldosterone levels will not offset the blood pressure control effect of this product. Eplerenone and spironolactone work on the same principle. Long-term use of spironolactone can cause endocrine disorders, while eplerenone has good tolerance and has the advantage of having few side effects, avoiding the side effects of endocrine disorders.

Eplerenone can be used for congestive heart failure after acute myocardial infarction. Eplerenone can improve the quality of life of patients with left ventricular dysfunction (ejection fraction ≤ 40%). Clinical trials have proven that this product can also be used for congestive heart failure after acute myocardial infarction.

In accordance with the Endocrine Society Clinical Practice Guidelines, its use is contraindicated in patients with Addison's disease. Hypersensitivity to eplerenone or any component of the formulation; initial serum potassium >5 meq/L; severe hepatic impairment (Child-Pugh class C); clinically significant hyperkalemia; concurrent use with potassium supplements or potassium-sparing diuretics.

Avoid potassium supplements, potassium-containing salt substitutes, potassium-rich diets, or other medications that may cause hyperkalemia (e.g., other potassium-sparing diuretics, nonsteroidal anti-inflammatory drugs). Concomitant use of potassium supplements or potassium-sparing diuretics is contraindicated in the treatment of hypertension. Untreated hypertension 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.