Eplerenone | Side Effects, Dosage, Uses & More
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Generic Name:

eplerenone, Oral tablet

All Brands

  • Inspra
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Highlights for eplerenone

Oral tablet
1

Eplerenone is an oral drug that’s used to treat hypertension (high blood pressure) and heart failure after you have a heart attack. It may be used alone or in combination with other drugs to treat your condition.

2

Your dose depends on the condition that you’re treating and other health conditions that you have. Your doctor will decide a dose that’s right for you.

3

Eplerenone can cause a severe, life-threatening allergic reaction. Symptoms include trouble breathing, swelling of your throat or tongue, and hives.

4

If you have high blood pressure, you shouldn’t take this drug if you have certain other conditions. Tell your doctor if you have kidney problems, diabetes and protein in your urine, or if you’re taking potassium supplements.

5

Common side effects include dizziness, diarrhea, coughing, flu-like symptoms, tiredness, muscle weakness, irregular heartbeat, tingling, nausea, feeling dehydrated, swelling in legs,  confusion.

IMPORTANT INFORMATION

High blood potassium

This drug may raise the potassium levels in your blood. Your doctor will check your potassium levels while you take eplerenone. You shouldn’t take this drug if you:

  • have a high potassium level
  • take a blood pressure drug that affects your potassium level
  • take potassium supplements
  • have poor kidney function

What is eplerenone?

Eplerenone is a prescription drug. It’s available as an oral tablet. It’s also available as a generic drug. Generic drugs usually cost less. In some cases they may not be available in every strength or form as the brand. Talk to your healthcare provider to see if the generic will work for you.

Eplerenone may be taken as part of a combination therapy. This means you may need to take it with other medications.

Why it's used

Eplerenone is used to treat high blood pressure. Medicines that lower blood pressure reduce your chance of having a stroke or heart attack. Eplerenone is also used to help treat heart failure after a heart attack.

How it works

Eplerenone belongs to a class of drugs called aldosterone antagonists. A class of drugs refers to medications that work similarly. They have a similar chemical structure and are often used to treat similar conditions.

More Details

How it works

Eplerenone belongs to a class of drugs called aldosterone antagonists. A class of drugs refers to medications that work similarly. They have a similar chemical structure and are often used to treat similar conditions.

This medication interferes with the activity of a steroid called aldosterone. Aldosterone acts to increase the amount of sodium and water you retain, which can cause scarring of your organ tissues and high blood pressure. Eplerenone blocks aldosterone’s ability to act. This allows more water and sodium to leave your body. This helps to decrease your blood pressure and decrease the chance of scarring from excess sodium and water in your body.

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eplerenone Side Effects

Oral tablet

More Common Side Effects

The most common side effects that occur with eplerenone include:

  • high blood potassium levels

  • kidney problems

  • dizziness

  • diarrhea

  • coughing

  • flu-like symptoms, such as fever and body aches

  • tiredness

  • breast growth in men (gynecomastia)

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Side Effects

If you experience any of these serious side effects, call your doctor right away. If your symptoms are potentially life threatening, or if you think you’re experiencing a medical emergency, call 9-1-1.

  • kidney problems. Symptoms include:

    • dehydration
    • fatigue
    • swelling of your legs
    • confusion
    • decrease in urination
  • high potassium levels in your blood (hyperkalemia). Symptoms include:

    • muscle weakness
    • tiredness
    • irregular heartbeat
    • tingling
    • nausea
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

Eplerenone may cause drowsiness.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
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eplerenone May Interact with Other Medications

Oral tablet

Eplerenone can interact with other medications, herbs, or vitamins you might be taking. That’s why your doctor should manage all of your medications carefully. If you’re curious about how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Note: You can reduce your chances of drug interactions by having all of your prescriptions filled at the same pharmacy. That way, a pharmacist can check for possible drug interactions.

Food interactions

Eating grapefruit or drinking grapefruit juice can increase the amount of eplerenone in your body. If you’re going to eat or drink grapefruit juice, drink it at least 2 hours before or after taking eplerenone.

Medications that might interact with this drug

Antibiotics

These drugs can increase the levels of eplerenone in your body. This may cause more side effects.

These drugs include:

  • clarithromycin
  • telithromycin

Antidepressant drugs

These drugs can increase the levels of eplerenone in your body. This may cause more side effects.

These drugs include:

  • nefazodone

Antifungal drugs

These drugs can increase the levels of eplerenone in your body. This may cause more side effects.

These drugs include:

  • fluconazole
  • itraconazole
  • ketoconazole
  • posaconazole
  • voriconazole

Antiretroviral drugs

These drugs can increase the levels of eplerenone in your body. This may cause more side effects.

These drugs include:

  • atazanavir
  • boceprevir
  • darunavir
  • dasabuvir
  • indinavir
  • nelfinavir
  • ombitasvir
  • paritaprevir
  • ritonavir
  • saquinavir
  • telaprevir

High blood pressure drugs

Taking these drugs with eplerenone may increase your risk for low blood pressure, high blood potassium, and kidney problems.

These drugs include:

  • angiotensin receptor blockers, such as:
    • candesartan
    • eprosartan
    • irbesartan
    • losartan
    • olmesartan
    • telmisartan
    • valsartan
    • azilsartan
  • angiotensin-converting enzyme (ACE) inhibitors, such as:
    • benazepril
    • captopril 
    • enalapril
    • fosinopril
    • lisinopril
    • moexipril
    • perindopril
    • quinapril
    • ramipril
    • trandolapril

Mood stabilizer drugs

Eplerenone may increase the effects of these medications. This may cause more side effects.

These drugs include:

  • lithium

Pain drugs

Nonsteroidal anti-inflammatory drugs (NSAIDs) and COX-2 can decrease your kidney function when taken with eplerenone.

These drugs include:

  • COX-2 inhibitors
    • celecoxib
  • NSAIDs
    • diclofenac
    • ibuprofen
    • indomethacin
    • keoprofen
    • ketorolac
    • meloxicam
    • nabumetone
    • naproxen
    • piroxicam
    • ibuprofen
    • naproxen

Potassium sparing diuretics

These drugs can increase the potassium in your body when taken with eplerenone.

  • spironolactone
  • amiloride
  • triamterene

Potassium supplements

These supplements can increase the potassium in your body when taken with eplerenone.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Eplerenone warnings
kidney problems
People with kidney problems

If you have kidney problems, you may have an increased risk for higher potassium levels in your blood. Your doctor will monitor your kidneys and potassium levels to make sure it’s OK for you to keep taking eplerenone.

diabetes
People with diabetes

People with diabetes: You shouldn’t use eplerenone if you have diabetes and have protein in your urine. Doing so will put you at higher risk of developing hyperkalemia. Symptoms of hyperkalemia include:

  • muscle weakness
  • exhaustion
  • tingling
  • nausea
pregnant women
Pregnant women

Eplerenone is a category B pregnancy drug. That means two things:

  1. Research in animals hasn’t shown a risk to the fetus when the mother takes the drug.
  2. There aren’t enough studies done in humans to show if the drug poses a risk to the fetus.

Talk to your doctor if you’re pregnant or planning to become pregnant. Animal studies don’t always predict the way humans would respond. Therefore, this drug should only be used in pregnancy if clearly needed.

breastfeeding
Women who are breast-feeding

It isn’t known if eplerenone passes into breastmilk. If it does, it may cause serious effects in a breast-feeding child.

You and your doctor may need to decide if you’ll take eplerenone or breast-feed.

for seniors
For seniors

Older adults may process drugs more slowly. A normal adult dose may cause levels of this drug to be higher than normal in your body. If you’re a senior, you may need a lower dose or a different schedule.

for children
For children

Eplerenone hasn’t been studied as treatment for high blood pressure or heart failure in people younger than 18 years.

allergies
Allergies

Eplerenone can cause a severe allergic reaction. Symptoms include:

  • trouble breathing
  • swelling of your throat or tongue
  • hives

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

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How to Take eplerenone (Dosage)

Oral tablet

All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What are you taking this medication for?

Hypertension

Brand: Inspra

Form: Oral tablet
Strengths: 25 mg, 50 mg

Generic: eplerenone

Form: Oral tablet
Strengths: 25 mg, 50 mg
Adult dosage (ages 18–64 years)

The standard starting dose is 50 mg taken by mouth once per day. Your doctor may increase your dose to 50 mg taken twice per day, if needed.

Child dosage (ages 0–17 years)

There are no specific dosing recommendations for people younger than 18 years.

Senior dosage (ages 65 years and older)

There are no specific recommendations for senior dosing. Older adults may process drugs more slowly. A normal adult dose may cause levels of this drug to be higher than normal in your body. If you’re a senior, you may need a lower dose or a different schedule.

Special considerations

Kidney problems: Your doctor should start you on a lower dose or a different schedule if you have problems with your kidneys. You may have a higher risk of having too much potassium in your blood.

Heart failure after a heart attack

Brand: Inspra

Form: Oral tablet
Strengths: 25 mg, 50 mg

Generic: eplerenone

Form: Oral tablet
Strengths: 25 mg, 50 mg
Adult dosage (ages 18–64 years)

The standard starting dose is 25 mg taken by mouth once per day. Your doctor may increase your dose to 50 mg taken once per day, if needed.

Child dosage (ages 0–17 years)

Eplerenone hasn’t been studied in children with heart failure and shouldn’t be used in people younger than 18 years.

Senior dosage (ages 65 years and older)

There are no specific recommendations for senior dosing. Older adults may process drugs more slowly. A normal adult dose may cause levels of this drug to be higher than normal in your body. If you’re a senior, you may need a lower dose or a different schedule.

Special considerations

Kidney problems: Your doctor should start you on a lower dose or a different schedule if you have problems with your kidneys. You may have a higher risk of having too much potassium in your blood.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

Eplerenone comes with serious risks if you don’t take it as prescribed.

If you don't take it at all

If you don’t take this drug, your blood pressure will stay high. This will increase your chance of having a stroke or heart attack.

If you stop taking It suddenly

Don’t stop taking eplerenone without talking to your doctor. Stopping this drug suddenly can cause your blood pressure to spike. This can increase your risk for heart attack or stroke.

If you don't take it on schedule

You may not have good blood pressure control if you don’t take this drug on schedule. This can increase your chance for a heart attack or a stroke.

If you take too much

If you think that you’ve taken too much eplerenone, call your doctor or go to the emergency room right away. Taking too much eplerenone can lead to low blood pressure (hypotension). It can also lead to hyperkalemia, with symptoms that include:

  • muscle weakness
  • tiredness
  • irregular heartbeat
  • tingling
  • nausea

What to do if you miss a dose

If you forget to take your dose, take it as soon as you remember. If it’s just a few hours until the time for your next dose, then wait and only take one dose at that time.

Never try to catch up by taking two doses at once. This could cause toxic side effects.

How to tell if the drug is working

You’ll know if eplerenone is working when you check your blood pressure at home. If your blood pressure is at or below the goal your doctor set for you, the medication is working.

Eplerenone is used for long-term treatment.

Important considerations for taking eplerenone

Store eplerenone at room temperature

Keep it from 68–77°F (20–25°C).

Don’t freeze eplerenone.

Keep it away from light and high temperature.

Keep your drugs away from areas where they could get wet, such as bathrooms. Store this drug away from moisture and damp locations.

Travel

When traveling with your medication:

  • Always carry your medication with you, such as in your carry-on bag.
  • Don’t worry about airport X-ray machines. They can’t hurt your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled box with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.                  

Self-management

You may need to check your blood pressure at home. You should keep a log with the date, time of day, and your blood pressure readings. Bring this diary with you to your doctor appointments.

If your doctor asks you to check your blood pressure at home, you’ll need to purchase a blood pressure monitor. These are available at most pharmacies.

Clinical monitoring

During treatment with eplerenone, your doctor may do the following tests to check if the drug is working or is safe for you to keep taking:

  • blood pressure
  • liver function
  • kidney function
  • blood potassium

Hidden costs

If your doctor asks you to check your blood pressure at home, you’ll need a blood pressure monitor. These are available at most pharmacies.

Insurance

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be more suitable for you than others. Talk to your doctor about possible alternatives.

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How Much Does eplerenone Cost?

Oral tablet

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Lowest price for eplerenone

Walmart $32.00
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Walgreens $55.27
These prices represent the lowest priced national pharmacies for eplerenone on GoodRx. They may be lower than your insurance.

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These prices represent the lowest priced national pharmacies for eplerenone on GoodRx. They may be lower than your insurance.

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Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on July 6, 2016

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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