September 26, 2020

Pitt B(1), Remme W, Zannad F, Neaton J, Martinez F, Roniker B, Bittman R, Hurley S, Kleiman J, Gatlin M; Eplerenone Post-Acute Myocardial. Insights from an EPHESUS (Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study) substudy. Rossignol P(1), MĂ©nard J, Fay R. Eur J Heart Fail. May;8(3) Epub Feb Evaluation of eplerenone in the subgroup of EPHESUS patients with baseline left ventricular.

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To email a medicine you must sign up and log in. No elevations of serum potassium above 5.

No correlation was observed between plasma clearance of eplerenone and creatinine clearance. Because of the unknown potential for adverse effects on the breast fed infant, a decision should be made whether to discontinue breast-feeding or discontinue the drug, taking into account the importance of the drug to the mother. Steady ephesis is reached within 2 days.

Cumulative Kaplan—Meier estimates of rates of the primary outcome according to study group.

At these doses, the highest observed eplerenone concentrations in paediatric subjects were not substantially higher than those in adults initiated at 50 mg once daily. Erratum in N Engl J Med.

EPHESUS – Wiki Journal Club

Overall mortality was low with death reported in 3 of patients 0. This site uses cookies. Comment in J Fam Pract. The effect of aldosterone antagonists for ventricular arrhythmia: The effect of eplerenone on the primary endpoint outcomes was consistent across all pre-specified subgroups.


The prostatic changes were not associated with adverse functional consequences.

Eplerenone 50 mg film-coated tablets – Summary of Product Characteristics (SmPC) – (eMC)

Eplerenone has been shown to reduce mortality in patients with HF, particularly in those with a recent MI and left ventricular dysfunction and in those with chronic heart ephesuus with low LVEF and mild symptoms. No initial dose adjustment is necessary for patients with mild-to-moderate hepatic impairment.

After a mean follow-up of After initiation, the dose should be adjusted based on the serum potassium level as shown in Table 1. Most of the subjects No studies on the effect of eplerenone on the ability to drive or use machines have been performed. Email alerts New issue alert. Oxford University Press is a department of the University of Oxford. If this combination appears necessary, lithium plasma concentrations should be monitored see section 4.

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Pharmacodynamic effects Eplerenone has been shown to produce sustained increases in plasma renin and serum aldosterone, consistent with inhibition of the negative regulatory feedback of aldosterone on renin secretion. Pregnancy There are no adequate data on the use of eplerenone in pregnant women. This is reassuring given the instability of patients with acute STEMI within the first hours of hospitalization. ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation.


Caution is warranted when warfarin is dosed near the upper limit of therapeutic range. Effect of MR blockade on collagen eohesus and cardiovascular disease with a specific emphasis on heart failure.

No cases of adverse events associated with overdose of eplerenone in humans have been reported. Prohibited concomitant medications included aldosterone antagonists, spironolactone, potassium canrenoate, potassium-sparing diuretics, potent cytochrome p 3A4 CYP3A4 inhibitors and inducers. Primary outcome, component events, and key secondary outcomes a.

For post-MI heart failure patients: Eplerenone metabolism is primarily mediated via CYP3A4. The addition of eplerenone to ephssus medical therapy reduces morbidity and mortality among patients with acute myocardial infarction complicated by left ventricular dysfunction and heart failure.

The concomitant use of eplerenone with strong CYP3A4 inhibitors such as ketoconazole, itraconazole, ritonavir, nelfinavir, clarithromycin, telithromycin and nefazadone, is contra-indicated see section 4. Please check for further notifications by email. Due to the risk of decreased eplerenone efficacy, the concomitant use of strong CYP3A4 inducers rifampicin, carbamazepine, phenytoin, phenobarbital, St John’s wort with eplerenone is not recommended see section 4.

Co-administration of eplerenone and lithium should eplerenlne avoided.