依普利酮需要注意什么事项呢？

It is a new type of selective aldosterone receptor antagonist that inhibits the renin-angiotensin aldosterone system, inhibits left ventricular remodeling, and is a potassium-sparing diuretic. Clinically, eplerenone can achieve good results in patients with hypertension who have unsatisfactory combined antihypertensive effects. It can also be used in patients with congestive heart failure after acute myocardial infarction. The combined use of ACEI and beta-blockers can inhibit myocardial remodeling, improve quality of life, and reduce mortality.

What should I pay attention to when taking eplerenone?

(1) Eplerenone cannot be combined with potassium supplements, potassium-containing salts or contraindicated drugs (potassium-sparing diuretics, strong inhibitors of CYP450 liver enzymes).

(2) Non-steroidal anti-inflammatory drugs and lithium can affect the blood concentration of eplerenone and affect the efficacy.

(3) During the treatment of myocardial ischemia, patients should also pay attention to dietary regulation, develop good eating habits, eat small meals frequently, eat less cholesterol-rich foods (egg yolks, butter, fat meat, animal offal) and sugar, and eat more fresh vegetables and fruits.

(4) When evaluating patients with heart failure to receive eplerenone treatment, the eGFR (epidermal growth factor receptor) should be greater than 30ml/min/1.73m2 or the 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 eplerenone. Instruct patients with heart failure to discontinue use during episodes of diarrhea or dehydration or when circulating diuretic therapy is interrupted.

(5) People with high serum potassium, type 2 diabetes patients with microalbuminuria, high serum creatinine levels, and muscle intoxication clearance <50 mL/min should not take it.