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), Ménard 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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The elimination half-life of eplerenone is approximately 3 to 5 hours.

Early mineralocorticoid receptor blockade in primary percutaneous coronary epperenone for ST-elevation myocardial infarction is associated with a reduction of life-threatening ventricular arrhythmia.

Eplerenone is not a substrate or an inhibitor of P-Glycoprotein.

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

The use of potassium supplements after initiation of eplerenone therapy is not recommended, due to an increased risk of hyperkalaemia. The analyses of the adjudicated primary and secondary endpoints were conducted on data from all patients who had undergone randomization, according to the intention-to-treat principle, with the use of a Cox proportional-hazards model. Fractional flow reserve-guided percutaneous coronary intervention vs.

NYHA functional classification improved or remained stable for a statistically significant greater proportion of subjects receiving eplerenone compared to placebo. Because of these anticipated limitations, rather than relying on hard outcomes only, we included markers of subclinical HF into the primary endpoint. Published on behalf of the European Society of Cardiology.


The secondary endpoint of all cause mortality was met by Potassium levels should be monitored regularly in patients with impaired renal function, including diabetic microalbuminuria. Usefulness of biomarker strategy to improve GRACE score’s prediction performance in patients with non-ST-segment elevation acute coronary syndrome and low event rates.

These results confirm the blockade of the mineralocorticoid receptor in these populations. We suspect that eplefenone benefit on clinical endpoints would be larger in a higher risk population. Immediate mineralocorticoid receptor blockade improves myocardial infarct healing by modulation of eplerwnone inflammatory response. A randomized controlled study of finerenone vs.

Eplerenone 50 mg film-coated tablets

After initiation, the dose should be adjusted based on the serum potassium level as shown in Table 1. Alpha 1 blockers e.

To bookmark a medicine you must sign up and log in. Tricyclic anti-depressants, neuroleptics, amifostine, baclofen Co-administration of these drugs with eplerenone may potentially increase antihypertensive effects and risk of postural hypotension.

EPHESUS – Wiki Journal Club

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. In this randomized, placebo-controlled, double-blind trial, we assigned patients with acute STEMI and without a history of heart failure to receive either eplerenone eplerennone mg once wplerenone or placebo in addition to standard therapy.

The treatment-by-subgroup interaction was evaluated by means of a Cox proportional-hazards model with terms for treatment, subgroup, and their interaction. General disorders and administration site conditions. The tablets contain lactose and should not be administered in patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption.


Animal studies eplerrnone not indicate direct or indirect adverse effects with respect to pregnancy, embryofoetal development, parturition and postnatal development see section 5.

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Serum potassium levels exceeded 5. N Engl J Med. Find out more here. Eplerenone does not cause drowsiness epehsus impairment of cognitive function but when driving vehicles or operating machines it should be taken into account that dizziness may occur during treatment.

Arterial thrombosis limb, orthostatic hypotension. There were no deaths associated with the development of hyperkalaemia in patients randomized to eplerenone.

Eplerenone was started at a dose of 25 mg once daily and was to be increased to 50 mg once daily starting on eplwrenone 2 if serum potassium concentration was below 5. Since the use of eplerenone has not been investigated in patients with severe hepatic impairment, eplerenone is contraindicated in this patient group see section 4.

Eplerenone treatment was initiated at 25 mg once daily in paediatric patients and increased to 25 mg twice daily after 2 weeks and eventually to 50 mg twice daily, if clinically indicated.