- Hypertension:
- 50mg OD/BD
- Heart failure with reduced ejection fraction post-MI:
- Start with 25 mg OD
- Increase to a max of 50mg OD within 4 weeks as tolerated
Renal dosing
- Heart failure with reduced ejection fraction post-MI:
- eGFR 31-49: start 25mg OD, may increase to 25mg OD after 4 weeks, max 25 mg/day
- eGFR or CrCl <31: avoid use
Tablet:
- 25mg
- 50mg
Taken without regard to meals
Selective aldosterone antagonists; potassium-sparing diuretics
It antagonizes aldosterone-specific mineralocorticoid receptors, decreasing Na and water reabsorption and increasing K retention.
- Hyperkalemia
- Dizziness
- Fatigue
- Influenza-like symptoms
- Diarrhoea
- Cough
- Hyponatremia
- Vaginal bleeding
- Hyperlipidemia
- Hypersensitivity to components/class
- Potassium >5.5
- eGFR or CrCl <31 (heart failure use)
- CrCl <50 (HTN use)
- Cr >1.8 (female patients, HTN use)
- Cr >2.0 (male patients, HTN use)
- Type 2 DM with microalbuminuria (HTN use)
- Chloramphenicol
- Itraconazole
- Ketoconazole
- Lopinavir/ritonavir
- Potassium salts/supplements
- Mifepristone
- Amiloride
- Atazanavir
- Clarithromycin
- Spironolactone
- Triamterene
- Voriconazole
- Saquinavir
- Nefazodone
- Tripanavir
Drug Status
| Availability | Prescription only |
| Pregnancy | Category B; Can be used |
| Breastfeeding | Use with caution |
| Schedule | Not controlled |
| BRAND NAME | STRENGTH | FORMULATION | PACK SIZE | MANUFACTURER | DISTRIBUTOR |
|---|---|---|---|---|---|
| Ep-life | 25mg | Tablet | 30’s | Innocia Lifesciences | Wessex Pharma |
| Ep-life | 50mg | Tablet | 30’s | Innocia Lifesciences | Wessex Pharma |
| Epnone | 50 mg | Tablet | 30’s | MSN Labs | Simba Pharma |
| Epnone | 25mg | Tablet | 30’s | MSN Labs | Simba Pharma |
| Inspra | 25mg | Tablet | 30’s | Pfizer Labs | Pfizer Labs |