Eplerenone

Introduction

Written by Patricia Weiser, PharmD
Medically reviewed by Dena Westphalen, PharmD
Updated on September 7, 2023

Eplerenone (e PLER en one) is a generic medication prescribed to help treat high blood pressure. It’s also prescribed to treat heart failure after a heart attack. Eplerenone is a potassium-sparing diuretic (water pill). It belongs to a group of drugs called aldosterone antagonists.

Specifically, the Food and Drug Administration (FDA) has approved eplerenone to:

• improve heart function and survival in adults with heart failure that’s occurred after experiencing a recent heart attack
• to lower blood pressure in adults with high blood pressure

Side effects of eplerenone

Eplerenone may cause mild or serious side effects. More common mild side effects of eplerenone and its serious side effects are listed below. This article doesn’t include all possible side effects of the drug. Side effects can vary based on your age, overall health, and any other medications you take.

To learn more about eplerenone’s side effects, ask your doctor or pharmacist. You can also refer to the prescribing information for eplerenone listed in the “Resources” section.

Mild side effects

More common mild side effects reported with eplerenone are listed below. The drug’s side effects can vary depending on the condition being treated.

This article doesn’t include all possible mild side effects of the drug. To learn more about eplerenone’s side effects, refer to the prescribing information for eplerenone listed in the “Resources” section.

With many drugs, mild side effects may go away within a few days or a couple of weeks. If the side effects are bothersome, tell your doctor or pharmacist. They may be able to suggest ways to manage them.

Eplerenone oral tablet’s mild side effects include:

• gynecomastia (breast tissue growth in males*)
• dizziness
• headaches
• irregular vaginal bleeding
• mild allergic reaction†

* Sex and gender exist on spectrums. In this article, we use the term “male” to refer to a person’s sex assigned at birth.
† For details about this side effect, see the “Interactions and warnings for eplerenone” section.

Serious side effects

Serious side effects of eplerenone are listed below.

This article doesn’t include all possible serious side effects of the drug. To learn more about eplerenone’s side effects, refer to the prescribing information for eplerenone listed in the “Resources” section.

With many drugs, serious side effects are possible but not common. If you have serious side effects from this drug, call your doctor right away. If you’re having severe symptoms or a medical emergency, call 911 or a local emergency number.

In general, eplerenone’s serious side effects include:

• very high level of potassium in the blood, which may cause:
  • dizziness
  • nausea or vomiting
  • rapid or irregular heart rate
  • chest pain
• severe allergic reaction*

* For details about this side effect, see the “Interactions and warnings for eplerenone” section.

Common questions about eplerenone

Below you’ll find answers to a few commonly asked questions about eplerenone.

What brand names are available for eplerenone?

The brand-name version of eplerenone is Inspra.

Eplerenone is a generic drug. A generic medication is an identical copy of the active drug in a brand-name medication. (An active drug is the ingredient that makes a medication work.) Generic drugs are believed to be as effective and safe as brand-name drugs. And generic drugs typically cost less than brand-name drugs.

If you’d like to know more about how eplerenone compares with Inspra, talk with your doctor or pharmacist.

Is eplerenone similar to spironolactone?

Yes, spironolactone and eplerenone are similar drugs. They’re both potassium-sparing diuretics (water pills). Both drugs help your body get rid of extra fluid while holding on to potassium.

Both drugs belong to the same group of drugs: Aldosterone antagonists. They work by blocking the action of aldosterone (a hormone that controls your blood pressure). But spironolactone also affects other hormones, which may lead to more side effects than eplerenone.

If you have questions about how spironolactone differs from eplerenone, talk with your doctor or pharmacist.

How does eplerenone work? And how long does it take to start working?

Eplerenone’s mechanism of action (how it works) is to block a hormone in your body called aldosterone. This is a hormone that manages your blood pressure and can cause it to increase. By blocking the action of aldosterone, eplerenone helps prevent an increase in blood pressure.

Eplerenone begins working right away but takes time to provide its full benefit. In most cases, doctors slowly increase the dosage of eplerenone over the first 4 weeks of treatment. Within the first month of treatment, most people experience the full benefit of eplerenone for treating their condition.

If you’d like to know more about how eplerenone works, talk with your doctor or pharmacist.

Can I take eplerenone with potassium supplements?

No. You should not take eplerenone with potassium supplements, including salt substitutes. Doing so can raise your risk of very high levels of potassium in your blood. This condition is a possible side effect of eplerenone.

Having very high potassium levels can be life threatening. Symptoms of high potassium include:

• chest pain
• rapid or irregular heart rate
• nausea or vomiting

If you develop these symptoms, seek medical attention or call 911 or a local emergency number right away.

Talk with your doctor or pharmacist to find out more about avoiding potassium while taking eplerenone.

Is eplerenone an ACE inhibitor?

No, it is not. Eplerenone is a potassium-sparing diuretic (water pill). It belongs to a group of drugs called aldosterone antagonists. Angiotensin converting enzyme (ACE) inhibitors are a separate group of blood pressure medications.

Doctors may also prescribe an ACE inhibitor drug to help lower your blood pressure. An ACE inhibitor drug may also be prescribed if you develop heart failure after having a heart attack. Examples of ACE inhibitor drugs are lisinopril and quinapril.

Taking eplerenone together with an ACE inhibitor may raise your risk of developing high levels of potassium in your blood. Because of this risk, your doctor will order tests to check your potassium levels during treatment with these drugs.

If you’d like to know more about eplerenone or ACE inhibitors, talk with your doctor or pharmacist.

Uses of eplerenone

The Food and Drug Administration (FDA) approves prescription drugs such as eplerenone for certain conditions. Approved uses for eplerenone are described below.

Use for high blood pressure

Doctors may prescribe eplerenone oral tablet for treating high blood pressure. It’s used for this purpose in adults. It’s usually prescribed as a long-term treatment.

High blood pressure doesn’t usually cause symptoms. But having high blood pressure increases the risk of serious health problems, such as a heart attack and stroke. Lowering blood pressure reduces these risks.

Doctors may prescribe eplerenone together with other blood pressure medications.

Use for helping to improve heart function after a heart attack

Doctors may prescribe eplerenone oral tablet for treating heart failure in a certain situation. Specifically, the FDA has approved eplerenone to treat heart failure with reduced ejection fraction (HFrEF) caused by a recent heart attack. It’s used for this purpose in adults. It’s usually prescribed as a long-term treatment.

With HFrEF, damage to the heart weakens its ability to pump blood throughout your body. Symptoms of HFrEF may include:

• shortness of breath
• cough
• fatigue (low energy)
• tiring quickly when walking or exercising
• swelling due to fluid buildup in your feet, legs, or arms

Interactions and warnings for eplerenone

Below, you’ll find information about eplerenone’s possible interactions and warnings.

Interactions of eplerenone

Certain things may affect how a drug works. These include getting vaccines, consuming alcohol or certain foods, or taking the drug with other medications. This effect is called a drug interaction.

Before you take eplerenone, ask your doctor to check for possible interactions. Be sure to tell them about any of the following you take or use:

• prescription or over-the-counter drugs
• vitamins, herbs, or supplements

To learn about drug-condition interactions, see the “Warnings for eplerenone” section below.

Warnings for eplerenone

Some people should not take eplerenone, and others should take it cautiously.

Eplerenone could cause harm to people with certain health conditions. This effect is called a drug-condition interaction. Other factors can also affect whether eplerenone is a safe option for you.

Ask your doctor about specific warnings for eplerenone, and be sure to tell your doctor about your:

• current health, including any allergies to medications
• past health conditions or surgeries

Allergic reaction

Eplerenone can cause an allergic reaction in some people. Severe allergic reactions are rare but possible.

If you’ve had an allergic reaction to eplerenone or any of its ingredients, your doctor will likely not prescribe eplerenone. They can tell you about medications that are safer options for you.

A mild allergic reaction may cause the following symptoms:

• skin rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)

A severe allergic reaction may cause the following symptoms:

• swelling under your skin, usually in your hands, feet, eyelids, or lips
• swelling of your mouth, throat, or tongue, which can cause breathing problems

If you have an allergic reaction to eplerenone, call your doctor right away. If you have severe symptoms, call 911 or a local emergency number.

Overdose of eplerenone

You should not take more eplerenone than your doctor prescribes. For some drugs, doing so may lead to harmful effects or overdose.

If you think you’ve taken too much eplerenone, call your doctor or pharmacist right away. Or you could call 800-222-1222 to speak with someone at America’s Poison Centers. You can also use its online resource. If you have concerning symptoms, call 911 or a local emergency number immediately. You can also go to the closest emergency room.

Pregnancy or breastfeeding and eplerenone

Information about eplerenone and pregnancy and breastfeeding is described below.

Eplerenone and pregnancy

It’s not known whether eplerenone should be taken during pregnancy. If you’re planning a pregnancy or can become pregnant, talk with your doctor before taking this medication.

Eplerenone and breastfeeding

It’s not known whether eplerenone should be taken while breastfeeding. If you’re currently breastfeeding or planning to do so, talk with your doctor before taking this medication.

What to ask your doctor

Let your doctor know if you have questions about eplerenone or would like more details about it.

Here’s a list of some possible questions you may want to ask your doctor:

• Is it necessary to avoid any specific foods while taking eplerenone?
• Can I take eplerenone if I have kidney problems?
• What should I do if I miss a dose of eplerenone?
• How much water should I drink while taking a diuretic such as eplerenone?

Resources

• Eplerenone tablet, film coated. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/25a1c77c-7008-4b07-af14-5522a282783a/spl-doc
• Food and Drug Administration. (2023). Orange Book: Approved drug products with therapeutic equivalence evaluations. https://www.accessdata.fda.gov/scripts/cder/ob/index.cfm

Disclaimer: Optum Perks 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 another 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.