Eplerenone (patient information)

Why this medication is prescribed

Eplerenone is used alone or in combination with other medications to treat high blood pressure. Eplerenone is in a class of medications called mineralocorticoid receptor antagonists. It works by blocking the action of aldosterone, a natural substance in the body that raises blood pressure.

How this medication should be used

Eplerenone comes as a tablet to take by mouth. It is usually taken once or twice a day, with or without food. To help you remember to take eplerenone, take it around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take eplerenone exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Your doctor may start you on a low dose of eplerenone and increase your dose after 4 weeks.

Eplerenone controls high blood pressure but does not cure it. It may take 4 weeks or longer before you feel the full benefit of eplerenone. Continue to take eplerenone even if you feel well. Do not stop taking eplerenone without talking to your doctor.

Other uses for this medicine

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Special precautions

Before taking eplerenone:

• tell your doctor and pharmacist if you are allergic to eplerenone or any other medications.
• do not take eplerenone if you are taking amiloride (Midamor), amiloride and hydrochlorothiazide (Moduretic), itraconazole (Sporanox), ketoconazole (Nizoral), potassium supplements, spironolactone (Aldactone), spironolactone and hydrochlorothiazide (Aldactazide), triamterene (Dyrenium), or triamterene and hydrochlorothiazide (Dyazide, Maxzide).
• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, and nutritional supplements you are taking. Be sure to mention any of the following: angiotensin converting enzyme (ACE) inhibitors such as benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil, Zestril), and quinapril (Accupril); angiotensin II receptor antagonists such as eprosartan (Teveten), irbesartan (Avapro), losartan (Cozaar), olmesartan (Benicar), and valsartan (Diovan); aspirin and other nonsteroidal anti-inflammatory medications (NSAIDS) such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn); cimetidine (Tagamet); clarithromycin (Biaxin); danazol (Danocrine); delavirdine (Rescriptor); diltiazem (Cardizem, Dilacor, Tiazac); erythromycin (E.E.S., E-Mycin, Erythrocin); fluconazole (Diflucan); fluoxetine (Prozac, Sarafem); fluvoxamine (Luvox); HIV protease inhibitors such as indinavir (Crixivan), ritonavir (Norvir), and saquinavir (Fortovase, Invirase); isoniazid (INH, Nydrazid); lithium (Eskalith, Lithobid), metronidazole (Flagyl); nefazodone (Serzone); troleandomycin (TAO); verapamil (Calan, Covera, Isoptin, Verelan); and zafirlukast (Accolate). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• tell your doctor what herbal products you are taking, especially St. John' wort.
• tell your doctor if you have or have ever had high blood levels of potassium, diabetes, gout, or liver or kidney disease.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking eplerenone, call your doctor.

Special dietary instructions

Talk to your doctor about drinking grapefruit juice while taking this medicine.

Do not use salt substitutes containing potassium while you are taking eplerenone. If your doctor prescribes a low-salt or low-sodium diet, follow these directions carefully.

What to do if you forget a dose

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Side Effects

Minor Side Effects

Eplerenone may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• headache
• dizziness
• diarrhea
• stomach pain
• cough
• excessive tiredness
• flu-like symptoms
• breast enlargement or tenderness
• abnormal vaginal bleeding

Severe Side Effects

Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately:

• chest pain
• tingling in arms and legs
• loss of muscle tone
• weakness or heaviness in legs
• confusion
• lack of energy
• cold, gray skin
• irregular heartbeat

Eplerenone may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/MedWatch/report.htm] or by phone [1-800-332-1088].

Storage conditions needed for this medication

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

In case of emergency/overdose

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Symptoms of overdose may include:

• fainting
• dizziness
• blurred vision
• upset stomach
• tingiling in arms and legs
• loss of muscle tone
• weakness or heaviness in legs
• confusion
• lack of energy
• cold, gray skin
• irregular or slow heartbeat

Other information

Keep all appointments with your doctor and the laboratory. Your doctor will check your blood pressure regularly and order certain lab tests to check your body's response to eplerenone.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

Brand names

• Inspra®