依普利酮该如何使用？

Developed by Pfizer/Pharmacia with the trade name Inspra, eplerenone is a new generation of selective aldosterone antagonist. Eplerenone has definite efficacy in the treatment of hypertension, heart failure and myocardial infarction, has fewer adverse reactions and is well tolerated. Its outstanding advantage is that for severe hypertension that cannot be controlled by a combination of multiple antihypertensive drugs, the addition of eplerenone can significantly reduce blood pressure, especially the decrease in systolic blood pressure is more significant. For patients with severe heart failure and myocardial infarction, eplerenone combined with angiotensin-converting enzyme inhibitors (ACEI) and beta-blockers can improve quality of life and reduce mortality. 

How should eplerenone be used? Common doses for adults with congestive heart failure: Initial dose: 25 mg orally, once daily; gradually increase to target dose within 4 weeks as tolerated by the patient. Target dose: 50 mg, orally, once a day; Common dosage for adults with hypertension: eplerenone can be used alone or in combination with other antihypertensive drugs; Initial dose: 50 mg, orally, once a day; Maintenance dose: 50 mg, orally, once or twice a day; Maximum dose: 100 mg/day , a significant antihypertensive effect will appear within four weeks of taking the drug. Patients whose blood pressure does not respond adequately to the initial dose can increase to 50 mg twice a day. Patients with moderate to severe liver damage should use eplerenone with caution. As renal function declines, the risk of hyperkalemia increases. Patients with mild renal impairment should use it with caution. It may be disabled according to the indications and degree of damage. 

The most common side effects include: cough, diarrhea, abdominal pain, angina, myocardial infarction, proteinuria, headache, dizziness, fatigue, flu-like symptoms, etc. Other side effects include: gynecomastia, abnormal vaginal bleeding; increases (serum potassium, triglycerides, cholesterol, alanine aminotransferase, γ-glutamyl transferase, creatinine, uric acid levels), decreased serum sodium levels, etc.