依普利酮适用于什么病症？

It is a new type of selective aldosterone receptor blocker that can effectively control hypertension, reduce damage to target organs such as the heart, brain and kidneys, and improve microalbuminuria in patients with type 2 diabetes. Eplerenone is a new selective aldosterone receptor antagonist that was approved for clinical use by the U.S. Food and Drug Administration in 2002.

What conditions is eplerenone suitable for? 

1. Congestive heart failure after acute myocardial infarction: Eplerenone can improve the quality of life of patients with left ventricular dysfunction (ejection fraction ≤ 40%). Clinical trials have proven that eplerenone can also be used for congestive heart failure after acute myocardial infarction.

2. Anti-hypertensive: Eplerenone can be used alone or in combination with other anti-hypertensive drugs for the treatment of hypertension.

Precautions for eplerenone

Hyperkalemia: Hyperkalemia may occur; the risk of hyperkalemia is increased with renal impairment, proteinuria, diabetes mellitus, and in patients concurrently taking ACE (angiotensin-converting enzyme) inhibitors, angiotensin II inhibitors, NSAIDs, or moderate CYP3A inhibitors. Monitor closely for hyperkalemia; serum potassium increased dose-related during clinical trials. As hyperkalemia develops, dose reduction or treatment interruption may be necessary. If concomitant treatment with a moderate CYP3A4 inhibitor cannot be avoided, reduce the eplerenone dose. It is contraindicated in patients with potassium greater than 5.5 meq/L at the beginning of treatment.

Diabetes: Use with caution in patients with diabetes and post-myocardial infarction heart failure (especially those with proteinuria); the risk of hyperkalemia is increased.

Heart failure: When evaluating patients with heart failure to receive eplerenone treatment, eGFR (epidermal growth factor receptor) should be greater than 30ml/min/1.73m2 or creatinine should be less than or equal to 2.5mg/dL (men) or less than or equal to 2mg/dL (women) with no recent worsening, potassium less than 5meq/L and no history of severe hyperkalemia. If blood potassium levels are elevated, close monitoring and management are required. The manufacturer recommends that treatment should be discontinued if serum potassium is >6 meq/L. ACCF/AHA (American College of Cardiology Foundation) recommends that when serum potassium concentration is >5.5 meq/L or renal function worsens, discontinuation of the drug should be considered and the entire medical regimen should be carefully evaluated. Avoid conventional triple therapy and use a combination of ACE (angiotensin-converting enzyme) inhibitors, ARB (one of the first-line treatments for hypertension) and. Instruct patients with heart failure to discontinue use during episodes of diarrhea or dehydration or when circulating diuretic therapy is interrupted.