Eplerenone

What is eplerenone?

Eplerenone is a prescription medicine that’s widely used to treat certain heart conditions. It belongs to a class of drugs known as aldosterone antagonists, being used to reduce fluid build-up and strain on the heart. It is also known by the brand name Inspra[1]. 

What is eplerenone used for?

Eplerenone is used to treat heart failure, particularly after a heart attack. It can also reduce the risk of hospitalisation and death in people with heart problems, while lowering blood pressure and improving your heart function[1]. 

How does eplerenone work?

Eplerenone works by blocking the action of aldosterone – a hormone that causes the body to retain salt and water. By preventing this effect, eplerenone helps the body get rid of excess salt and fluid. This then reduces blood pressure and eases the workload on the heart[1]. 

Who can take eplerenone?

Most adults can take eplerenone safely. However, it may not be suitable for people who have high potassium levels, type 2 diabetes, severe kidney or liver disease or are allergic to eplerenone. It’s also generally not recommended for people who are pregnant, trying to get pregnant or are breastfeeding, unless advised by a doctor[1]. 

Please tell your doctor or pharmacist about any conditions you may have or medication you take before you start treatment, and always follow the instructions in the Patient Information Leaflet[2].  

How do you take eplerenone?

For most conditions, you will usually take eplerenone once a day at the same time each day. It can be taken with or without food. You should swallow the tablet whole with water, following your doctor or pharmacist’s instructions carefully[1]. 

What is the typical dosage of eplerenone?

Eplerenone comes as 25mg and 50mg tablets. The usual starting dose of eplerenone for adults is 25mg once daily. Then, after some weeks, the dose may be increased to 50mg once daily. Your dosage adjustments are made based on kidney function and blood potassium levels, and your medical professional may arrange regular blood tests to ensure the dose is right for you[1]. 

Can you stop taking eplerenone suddenly?

You should not stop taking eplerenone suddenly without medical advice as doing so could cause your heart condition to worsen. It’s best to always speak to your doctor or pharmacist before making any changes to your treatment[1]. 

What should you do if you take too much eplerenone?

If you take too much eplerenone, you may experience a range of symptoms – from dizziness or fainting due to low blood pressure to high potassium levels and weakness or irregular heartbeat. If you experience any of these symptoms while taking eplerenone, call 111 or contact your doctor immediately. Go to A&E if your symptoms are severe[1]. 

What should you do if you forget a dose of eplerenone?

If you forget a dose of eplerenone, you have two options[1]: 

• You can take it as soon as you remember if not much time has passed since it was due 

• If it is nearly time for your next dose, skip the missed dose altogether and continue from the next one 

Do not take a double dose to make up for a missed one. 

What medicines should you avoid while taking eplerenone?

It’s important to avoid taking the following medicines while you are on eplerenone as they may interact[1]: 

• High blood pressure medicine like ramipril, enalapril, losartan, or candesartan 

• Eczema or psoriasis medicine like tacrolimus or ciclosporin 

• Antibiotics like trimethoprim, clarithromycin, erythromycin, or rifampicin 

• HIV medication 

• Bipolar medicines like lithium 

• Heart condition medicines like digoxin or amiodarone 

• Fungal medicines like fluconazole or itraconazole 

• Epilepsy medicines like phenytoin, carbamazepine, or phenobarbital 

• Potassium-affecting medicines like spironolactone or amiloride 

• Blood clot medication like warfarin 

Always inform your doctor or pharmacist about all medications and supplements you take before you start a new medicine, and follow the instructions in the Patient Information Leaflet[2]. 

What are the side effects of eplerenone?

The most common side effects of eplerenone are having high potassium levels (hyperkalaemia), or experiencing dizziness, headaches, diarrhoea, coughing, insomnia, and tiredness[1]. 

There is a small chance you could experience more serious side effects, which require medical attention. These include signs of severe dehydration, loss of kidney function or extremely high potassium levels, including muscle cramps, diarrhoea, sickness, weakness, dizziness, problems peeing, and confusion[1]. 

You should contact your GP if you experience any of these symptoms. In rare cases, the medicine may cause a serious allergic reaction (anaphylaxis). You should call 999 or visit A&E immediately if you believe this is happening[1]. 

Symptoms of anaphylaxis include[1]:  

• Difficulty breathing  

• Tightness in throat and chest  

• Swelling of the tongue or throat  

• Feeling faint or dizzy  

• Blue/grey skin or lips  

• Loss of consciousness 

If you experience any side effects, including those not listed, you are encouraged to report them via the Yellow Card Scheme or contact your doctor, pharmacist, or nurse. This information is intended as a summary for general awareness and does not replace professional medical advice. 

The information provided in the side effects section is not a comprehensive list of all possible side effects associated with this medication. For a complete list of side effects, please refer to the Patient Information Leaflet (PIL) provided with your medication or consult your healthcare professional[2]. 

Frequently asked questions about eplerenone

How long does eplerenone take to work? 

After you start taking eplerenone, you may start to notice effects within a few weeks – but it can take longer for the full benefits to appear[1]. 

Can I drink alcohol while taking eplerenone? 

Yes, you can drink alcohol in moderation while taking eplerenone, however it’s best to limit this as it can cause unwanted side effects[1]. 

Is eplerenone safe during pregnancy? 

Eplerenone is not usually recommended during pregnancy. You can speak to your doctor or pharmacist if you are pregnant or planning to become pregnant while taking eplerenone[1]. 

Can I take eplerenone with food? 

You can generally take eplerenone either with or without food – speak to your doctor or pharmacist for the best advice[1]. 

What should I do if I miss a dose of eplerenone? 

If you miss a dose of eplerenone, take it as soon as you remember unless it is close to your next dose. Do not double up as this can cause serious side effects[1]. 

Can I take eplerenone with other heart medicines? 

You can sometimes take eplerenone with other heart medicines, but your medical professional will need to check for possible interactions to make sure everything is safe[1]. 

Does eplerenone cause weight gain? 

Eplerenone does not typically cause weight gain. Speak to your doctor or pharmacist for advice if you experience unexplained weight gain while taking it[1]. 

Do I need regular blood tests while taking eplerenone? 

Yes, you will need regular tests to check your potassium levels and kidney function while you’re taking eplerenone. This is precautionary and to make sure everything is working well[1]. 

Can I stop taking eplerenone if I feel better? 

You shouldn’t suddenly stop taking a regular dose of eplerenone – always speak to your doctor or pharmacist first. Stopping suddenly may make your condition worse[1]. 

For the official NHS guide to eplerenone, visit their website.