eplerenone怎么用？

How to use it? 

Common dosage for adults with congestive heart failure: Initial dose: 25 mg, orally, once a day; and within 4 weeks, gradually increase to the target dose, as tolerated by the patient, to a target dose of 50 mg, orally, once a day.

Common dosages for adults with hypertension: eplerenone can be used alone or in combination with other antihypertensive drugs. Initial dose: 50 mg, taken orally, once a day. Maintenance dose: 50 mg, taken orally, 1-2 times a day. Maximum dose: 100 mg/day. Obvious antihypertensive effects appear within four weeks of medication. Patients whose blood pressure responds inadequately to the initial dose may be increased to 50 mg twice daily.

The clinical trial included 499 patients with grade 1 or 2 hypertension to analyze the effect of enalapril or eplerenone in treating hypertension. Patients were randomized to receive enalapril or eplerenone. A comparative study on the efficacy and tolerability of 499 patients with grade 1 or 2 hypertension who were randomized to receive enalapril or eplerenone showed that at 6 months, enalapril was as effective as eplerenone in reducing systolic blood pressure (eplerenone decreased by 14.5 mmHg; enalapril decreased by 12.7 mmHg: P=0.199) and diastolic blood pressure (eplerenone decreased by 11.2 mmHg; enalapril decreased by 11.3 mm). Hg; P=0.910). After 12 months, the two groups were also similar (eplerenone-16.5/-13.3mmHg; enalapril-14.8/-14.1mmHg, P values ​​0.251 and 0.331 respectively). The rates of withdrawal due to adverse events (7.9% for eplerenone and 9.3% for enalapril at 6 months) and treatment failure were also equal (23.3% for eplerenone and 22.8% for enalapril at 6 months). About 2/3 of the patients in each group achieved normal blood pressure at 6 months with the above single treatment. In the eplerenone group, the reduction in blood pressure was independent of renin levels, unlike enalapril. Both groups could reduce proteinuria above normal levels, but the eplerenone group was more significant (-61.5% vs -25.7%; P=0.01). Subgroup analysis of the study showed that the effect of eplerenone on reducing overall mortality was more obvious in patients with hypertension. Not only that, eplerenone can improve the quality of life of patients with left ventricular dysfunction (ejection fraction ≤ 40%). Clinical trials have proven that it can also be used for congestive heart failure after acute myocardial infarction.