eplerenoon

Note: The term eplerenoon is a common misspelling of eplerenone, a selective aldosterone receptor antagonist used in cardiovascular disease. Eplerenone belongs to the class of mineralocorticoid receptor antagonists and is more selective for the aldosterone receptor than older drugs such as spironolactone, which can cause broader hormonal side effects.

Eplerenone is prescribed mainly for heart failure with reduced ejection fraction and for certain cases of hypertension. In heart failure, it helps reduce morbidity and mortality by blocking the effects of aldosterone on the heart and vessels, which can promote fluid retention, fibrosis, and remodeling. It may be used after a myocardial infarction in patients with left ventricular dysfunction to improve outcomes. It is also used as part of combination therapy in hypertensive patients who require additional blood pressure control.

Mechanism and pharmacology: Eplerenone selectively binds to and inhibits mineralocorticoid receptors, decreasing sodium reabsorption in the distal nephron and reducing potassium loss. This potassium-sparing action must be balanced against the risk of hyperkalemia, especially in patients with renal impairment, concomitant renin–angiotensin system inhibitors, or NSAID use. The drug is taken orally and is primarily metabolized by the liver via cytochrome P450 enzymes.

Safety and monitoring: Hyperkalemia is the principal safety concern and requires regular monitoring of serum potassium and renal function. Common adverse effects include dizziness, gastrointestinal symptoms, and headaches. Eplerenone should be used with caution in patients with kidney disease or those taking other drugs that raise potassium levels.

Availability and history: Eplerenone was developed in the late 1990s and approved by major regulators in the early 2000s. It is available in generic form in many countries and is prescribed under various brand names.