依普利酮的注意事项有什么呢？

A new generation of selective aldosterone antagonist (eplerenone) has been approved as a new drug for the treatment of hypertension and other cardiovascular diseases. What are the advantages of eplerenone: (1) For the treatment of heart failure after acute myocardial infarction, combined use with standard treatment drugs can reduce the total mortality in the treatment group by 15% (P=0.008); (2) Eplerenone and enalapril are equally effective in reversing left ventricular hypertrophy and hypertension, with fewer cough side effects, and the combined effect is more obvious; (3) There are few adverse reactions, except for the adverse reactions of increased blood potassium, other adverse reactions are no different from the placebo group; (4) There are almost no sex hormone-related side effects of spironolactone.

What are the precautions for using eplerenone?

Hyperkalemia: Hyperkalemia may occur; 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 eplerenone with caution in patients with diabetes and post-myocardial infarction heart failure (especially those with proteinuria); it may increase the risk of hyperkalemia.

Hepatic Impairment: Use eplerenone with caution in patients with moderate to severe hepatic impairment.

Kidney damage: As kidney function decreases, the risk of hyperkalemia increases. Eplerenone should be used with caution in patients with mild renal impairment; eplerenone may be disabled depending on the indications and degree of impairment.

Drug-Drug Interactions: Significant interactions of eplerenone with other drugs may exist, requiring dose or frequency adjustment, additional monitoring, and/or the selection of alternative therapies.

Pregnancy: Untreated hypertension and heart failure are both associated with adverse pregnancy outcomes. Its use is not recommended for the treatment of chronic isolated hypertension in pregnant women, and eplerenone should generally be avoided in women of reproductive potential.