依普利酮的用药指南和特殊人群用药

Eplerenone is an aldosterone receptor antagonist. The active ingredient is eplerenone, which works by blocking the binding of aldosterone to the mineral corticosteroid receptor. Based on its lowering of blood pressure and improvement of heart function, eplerenone can significantly reduce the risk of cardiovascular events.

Indications of eplerenone

1. Heart failure after myocardial infarction

Patients with stable heart failure and significantly reduced left ventricular ejection fraction (≤40%) after myocardial infarction can be treated. It can significantly improve the patient's survival rate and effectively reduce the risk of cardiovascular mortality and readmission.

2. Hypertension

Eplerenone can also be used to treat hypertension in adults.

The pictures come from public channels (such as the official website of the FDA, the official website of the original drug manufacturer, etc.) and are for reference only.

Eplerenone Medication Guide

The usage and dosage of eplerenone only reflect the usage and dosage standards of the country where the drug is registered overseas, and do not serve as any basis for medication.

1. Heart failure after myocardial infarction (HFrEF)

(1) Initial dose

The initial dose is 25 mg, once a day. As tolerated by the patient, it is best to titrate to the recommended dose of 50 mg once daily within 4 weeks.

(2) Adjust the dose according to the serum potassium level

Serum potassium <5.0mEq/L: It can be adjusted from 25 mg once every other day to 25 mg once a day, or from 25 mg once a day to 50 mg once a day.

Serum potassium between 5.0-5.4mEq/L: No dosage adjustment is required.

Serum potassium is 5.5-5.9mEq/L: it needs to be adjusted from 50 mg once a day to 25 mg once a day, or from 25 mg once a day to 25 mg once every other day, or from 25 mg once every other day to suspension of medication.

Serum potassium ≥6.0mEq/L: The medication needs to be suspended. After the potassium level drops to <5.5mEq/L, treatment can be restarted with 25mg once every other day.

2. Hypertension

(1) Initial dose

The recommended starting dose is 50mg, once a day.

(2) Increase the dose

For patients whose blood pressure is not well controlled at 50 mg once daily, the dose may be increased to 50 mg twice daily.

Dose adjustment of eplerenone

Dose adjustment when combined with moderate CYP3A inhibitors

1. In patients with HFrEF after myocardial infarction, when combined with moderate CYP3A inhibitors, the dose should not exceed 25 mg, once a day.

2. When patients with hypertension are combined with moderate CYP3A inhibitors, the starting dose is 25 mg, once a day. If blood pressure is not well controlled, the dose can be increased to the maximum dose of 25 mg twice daily.

Eplerenone Medication Guide for Special Populations

1. Medication for Pregnant Women

There is currently very limited data on the use of eplerenone for pregnant women. Pregnant women with high blood pressure or heart failure should use the medication under close monitoring by a doctor to weigh the benefits of treatment and potential risks.

2. Lactating women

It is unclear whether eplerenone enters human milk. In animal experiments, the drug can be excreted through milk. It is recommended that lactating women suspend breastfeeding while taking eplerenone or consult their doctor to choose a safer alternative.

3. Men and women of childbearing age

Animal studies have initially shown that eplerenone may have a certain impact on male fertility, but its impact on its human counterparts is still unclear. Men or women who are planning to have children should inform their doctor and they can decide together whether to continue taking the medication.

4. Children

The safety and effectiveness of eplerenone in children with hypertension have not yet been established. It is not recommended for patients under 18 years of age to use eplerenone to treat hypertension or heart failure.

5. Elderly patients

Elderly patients over 65 years old should use eplerenone with special caution.