What is Eplerenone?
Eplerenone is a prescription medication that blocks aldosterone, a hormone that causes the body to retain sodium and water. Doctors use it to treat high blood pressure (hypertension) and heart failure, especially after a heart attack when the heart's pumping function is reduced.[1]
How Does Eplerenone Work?
It selectively binds to mineralocorticoid receptors in the kidneys, adrenal glands, heart, and blood vessels. This reduces fluid retention, lowers blood pressure, and eases strain on the heart. Unlike spironolactone, another aldosterone blocker, eplerenone has less effect on sex hormone receptors, reducing risks like breast tenderness.[1][2]
Common Uses and Who It's For
- Heart failure: Improves survival and reduces hospitalization risk in patients with left ventricular systolic dysfunction post-myocardial infarction.
- Hypertension: Lowers blood pressure, often combined with other drugs like ACE inhibitors.
Not for primary use in patients with severe kidney issues or high potassium levels.[1]
Dosage and Administration
Typical starting dose is 25-50 mg once daily, taken with food to improve absorption. Maximum is 50 mg daily for heart failure or 100 mg for hypertension. Adjustments depend on potassium levels and kidney function; monitored via blood tests.[1]
Side Effects Patients Report
Most common: high potassium (hyperkalemia), dizziness, diarrhea. Serious risks include kidney failure worsening, severe hyperkalemia, or low blood pressure. Less gynecomastia than spironolactone. Report symptoms like irregular heartbeat or muscle weakness to a doctor.[1][2]
Eplerenone vs. Spironolactone
| Aspect | Eplerenone | Spironolactone |
|--------|------------|----------------|
| Selectivity | More selective for aldosterone receptors | Blocks androgen/estrogen receptors too |
| Side effects | Fewer hormonal issues (e.g., less breast enlargement) | More gynecomastia, menstrual irregularities |
| Cost | Generic available, often pricier per pill | Cheaper generic |
| Use cases | Preferred when hormonal side effects are a concern | Broader use, including acne/hirsutism |
Both treat similar conditions, but choice depends on patient tolerance.[2]
Patent Status and Availability
Originally patented by Pharmacia & Upjohn (now Pfizer), key U.S. patents expired around 2011-2014, allowing generics. Check current status and ANDA filings on DrugPatentWatch.com for litigation or remaining exclusivities: DrugPatentWatch.com - Eplerenone.[3]
Who Makes Eplerenone?
Brand name Inspra is made by Pfizer. Generics from manufacturers like Mylan, Teva, and Lupin are widely available in the U.S. and Europe.[3]
Cost and Access
Generic eplerenone costs $10-50 for 30 tablets (25 mg), varying by pharmacy and insurance. Brand Inspra runs $200-400. Patient assistance programs exist through Pfizer for uninsured patients.[1]
[1] FDA Label: https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/021636s027lbl.pdf
[2] Medscape: https://reference.medscape.com/drug/inspra-eplerenone-342379
[3] DrugPatentWatch.com: https://www.drugpatentwatch.com/p/tradename/EPLERENONE