Side Effects of eplerenone: A Synthesis of Findings from 28 Studies

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Original Abstract of the Article

Major Research Findings

Eplerenone is a mineralocorticoid receptor antagonist (MRA) used to treat conditions like high blood pressure and heart failure. Several studies have shown that eplerenone can have beneficial effects on heart and kidney health. For example, 8 indicates that eplerenone can help improve heart function in patients with heart failure. Additionally, 14 suggests that eplerenone might slow the progression of diabetic kidney disease. Furthermore, 5 shows that eplerenone can help reduce the risk of heart and kidney complications.

Reasons for Side Effects

Eplerenone works by blocking the effects of aldosterone, a hormone that helps regulate blood pressure and kidney function. However, aldosterone also plays a role in maintaining electrolyte balance in the body. Therefore, taking eplerenone can disrupt this balance, leading to side effects like high potassium levels (hyperkalemia).

Common Side Effects

Hyperkalemia

Eplerenone can increase potassium levels in the body, as it inhibits the action of aldosterone, which promotes potassium excretion. High potassium levels can lead to heart rhythm abnormalities. 19 , 10 , 14 , 5 , 16

Chest Pain

This side effect is reported in 3 .

Gastrointestinal Symptoms

Eplerenone may cause gastrointestinal symptoms because aldosterone also affects the digestive system. These symptoms can include nausea, vomiting, and abdominal pain. 19

Headache

This side effect is reported in 19 .

Dizziness

This side effect is reported in 19 .

Rash

This side effect is reported in 19 .

Sexual Dysfunction

Eplerenone can cause sexual dysfunction because it can inhibit the effects of male hormones. These issues can include erectile dysfunction and ejaculation problems. 19 , 28

Side Effect Management

Hyperkalemia

To prevent hyperkalemia, it's important to limit potassium intake in your diet. Regular blood tests should be conducted to monitor potassium levels. If you experience symptoms of hyperkalemia, consult your doctor. 10

Comparison between Studies

Commonalities

Multiple studies have shown that eplerenone can have beneficial effects on heart and kidney health. Also, several studies have indicated that eplerenone can cause side effects like hyperkalemia.

Differences

The effectiveness and severity of side effects from eplerenone vary across studies. This variability can be attributed to differences in factors like the age, gender, medical conditions, and dosage of the participants. Additionally, differences in study methods and assessment criteria may also contribute to variations in results.

Important Considerations for Real-Life Application

While eplerenone may offer benefits for heart and kidney health, it also carries the risk of side effects like hyperkalemia. Before starting eplerenone, consult your doctor to ensure it's appropriate for your condition. During treatment, regular blood tests should be done to monitor your potassium levels. If you experience symptoms of hyperkalemia, contact your doctor.

Current Limitations in Research

There's still not enough research on eplerenone, especially regarding long-term effects. More research is needed to determine if eplerenone can be safely used for long durations.

Future Research Directions

Further research is necessary to investigate the long-term effects of eplerenone, particularly its effects on the heart and kidneys. Additionally, studies comparing eplerenone's safety and effectiveness to other treatments are needed.

Conclusion

Eplerenone is a medication that could potentially benefit heart and kidney health. However, it also carries the risk of side effects like hyperkalemia. Consulting your doctor before starting eplerenone to ensure its suitability for you is crucial. Regular blood tests should be conducted to monitor your potassium levels during treatment. If you experience hyperkalemia symptoms, seek medical advice.

Literature analysis of 28 papers
Positive Content
26
Neutral Content
0
Negative Content
2
Article Type
2
1
2
12
28
3.

The Effectiveness of Eplerenone vs Spironolactone on Left Ventricular Systolic Function, Hospitalization and Cardiovascular Death in Patients With Chronic Heart Failure-HFrEF.

Author: NaserNabil, Durak-NalbanticAzra, Sabanovic-BajramovicNirvana, KaricAlen

Reduced risk of HF hospitalization
Reduced risk of death

This review discusses the role of mineralocorticoid receptor antagonists (MRAs) in the treatment of heart failure. MRAs are recommended to reduce the risk of hospitalization and death in all patients with symptomatic heart failure and no contraindications.

Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

5.

The Nonsteroidal Mineralocorticoid-Receptor-Antagonist Finerenone in Cardiorenal Medicine: A State-of-the-Art Review of the Literature.

Author: GeorgianosPanagiotis I, AgarwalRajiv

Cardiorenal protection
Reduced cardiovascular and kidney failure risk
Hyperkalemia

Finerenone, a novel nonsteroidal mineralocorticoid receptor antagonist, has been approved for cardiorenal protection in patients with CKD associated with T2DM. Two phase 3 clinical trials, FIDELIO-DKD and FIGARO-DKD, demonstrated its efficacy in reducing cardiovascular and kidney failure risks.

ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

6.

Finerenone in diabetic kidney disease: A systematic review and critical appraisal.

Author: SinghAwadhesh Kumar, SinghAkriti, SinghRitu, MisraAnoop

CKD treatment
T2D treatment

This systematic review aims to assess the efficacy and safety of finerenone in patients with chronic kidney disease (CKD) with or without type 2 diabetes (T2D).

Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

8.

Mineralocorticoid receptor antagonists, heart failure and predictive biomarkers.

Author: KarthiganNikshay, LockwoodSiobhan, WhiteAnthony, YangJun, YoungMorag J

Heart failure treatment
Improved cardiac function
Side effects

This paper discusses the role of mineralocorticoid receptor antagonists in heart failure and the need for biomarkers that can predict response to treatment.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

9.

Real world comparison of spironolactone and eplerenone in patients with heart failure.

Author: Pardo-MartínezPatricia, Barge-CaballeroEduardo, Bouzas-MosqueraAlberto, Barge-CaballeroGonzalo, Couto-MallónDavid, Paniagua-MartínMaría J, Sagastagoitia-FornieMarta, Prada-DelgadoÓscar, MuñizJavier, Almenar-BonetLuis, Vázquez-RodríguezJosé M, Crespo-LeiroMaría G

Reduced mortality
Side effects

This observational, real-world, propensity-score matched study found that eplerenone was associated with lower cardiovascular mortality and lower all-cause mortality than spironolactone in patients with heart failure and reduced ejection fraction (HFrEF).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Observational StudyResearch that observes and collects data on participants' behavior and outcomes in their natural state, without intervention.

Language : English

14.

Mineralocorticoid Receptor Antagonists in Diabetic Kidney Disease.

Author: Vodošek HojsNina, BevcSebastjan, EkartRobert, PikoNejc, PetreskiTadej, HojsRadovan

Cardiorenal benefits
Reduced hyperkalemia

This review summarizes the current knowledge and research on mineralocorticoid receptor antagonists (MRA) in the treatment of diabetic kidney disease (DKD). Non-steroidal MRAs have shown promise as they block the damaging effects of mineralocorticoid receptor overactivation with fewer side effects than steroidal MRAs.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

15.

The expanding class of mineralocorticoid receptor modulators: New ligands for kidney, cardiac, vascular, systemic and behavioral selective actions.

Author: BădilăE

Chronic kidney disease treatment
Heart failure treatment
Hyperkalemia

Nonsteroidal mineralocorticoid receptor antagonists, such as finerenone, show promise in treating chronic kidney disease and heart failure, as they provide renoprotective effects and inhibit inflammation without the side effects of traditional steroid-based antagonists.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

16.

Severe hyperkalaemia due to a potential drug-drug interaction between eplerenone and antiretrovirals in a HIV-positive patient after a myocardial infarction.

Author: CordovaEzequiel, GaribaldiFranco, BonoLeandro, RodriguezClaudia

Hyperkalemia

Eplerenone, a medication used to treat high blood pressure, can interact with ritonavir, a drug used to treat HIV, increasing the risk of dangerously high potassium levels.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

17.

Comparative study of spironolactone and eplerenone in management of ascites in patients of cirrhosis of liver.

Author: SehgalRishabh, SinghHarsimranjit, SinghInder Pal

Effective ascites management
Fewer side effects

This study found that eplerenone and spironolactone are equally effective in treating ascites due to liver cirrhosis. However, eplerenone had a better side effect profile, especially regarding gynecomastia and hyperkalemia.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

18.

Eplerenone Versus Spironolactone in Resistant Hypertension: an Efficacy and/or Cost or Just a Men's Issue?

Author: ManolisAntonis A, ManolisTheodora A, MelitaHelen, ManolisAntonis S

Resistant hypertension treatment

Eplerenone, a selective mineralocorticoid receptor antagonist, may offer an alternative to spironolactone for resistant hypertension.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

19.

Adverse Effects of Mineralocorticoid Receptor Antagonist Administration.

Author: KallistratosManolis S, PittarasAndreas, TheodoulidisIakovos, GrassosCharris, PoulimenosLeonidas E, ManolisAthanasios J

Hyperkalemia
Renal function deterioration

Mineralocorticoid receptor antagonists are associated with an increased risk of hyperkalemia and acute deterioration of renal function. These adverse effects are dose-dependent, more common during the initial period of treatment, and are usually reversible after withdrawal.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

22.

Mineralocorticoid receptor antagonism improves diastolic dysfunction in chronic kidney disease in mice.

Author: BonnardBenjamin, Pieronne-DeperroisMarie, DjeradaZoubir, ElmoghrabiSoumaya, KolkhofPeter, Ouvrard-PascaudAntoine, MulderPaul, JaisserFrédéric, MessaoudiSmail

CKD complications
Prevent cardiac dysfunction
Hyperkalemia

Finerenone, a new non-steroidal mineralocorticoid receptor antagonist (MRA), was found to prevent cardiac complications of renal failure in a mouse model of chronic kidney disease (CKD). Finerenone improved cardiac function and reduced fibrosis without affecting renal dysfunction or potassium levels.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

23.

Effect of Eplerenone on the Glomerular Filtration Rate (GFR) in Primary Aldosteronism: Sequential Changes in the GFR During Preoperative Eplerenone Treatment to Subsequent Adrenalectomy.

Author: NakanoYujiro, YoshimotoTakanobu, FukudaTatsuya, MurakamiMasanori, BouchiRyotaro, MinamiIsao, HashimotoKoshi, FujiiYasuhisa, KiharaKazunori, OgawaYoshihiro

Reversal of glomerular hyperfiltration

Eplerenone can, at least partially, reverse glomerular hyperfiltration in primary aldosteronism.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

24.

Nonsteroidal mineralocorticoid antagonists in diabetic kidney disease.

Author: DojkiFarheen K, BakrisGeorge

DKD treatment

Excess aldosterone may play a role in diabetic kidney disease (DKD) by promoting glomerular hypertrophy, glomerulosclerosis, and proteinuria. Nonsteroidal mineralocorticoid receptor antagonists (MRAs) are being investigated as potential treatments for DKD.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

25.

Eplerenone for hypertension.

Author: TamTina Sc, WuMay Hy, MassonSarah C, TsangMatthew P, StablerSarah N, KinkadeAngus, TungAnthony, TejaniAaron M

Heart failure treatment
Hypertension treatment

Eplerenone is an aldosterone receptor blocker used to treat heart failure and high blood pressure. This review examines the clinical impact of eplerenone on cardiovascular morbidity, mortality, and blood pressure lowering in patients with hypertension.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

27.

Should All Patients with Resistant Hypertension Receive Spironolactone?

Author: RosaJán, ZelinkaTomáš, PetrákOndřej, ŠtrauchBranislav, HolajRobert, WidimskýJiří

Resistant hypertension treatment
None mentioned

Resistant hypertension is a common condition that requires proper identification and treatment. This review focuses on the use of mineralocorticoid receptor antagonists, particularly spironolactone, in the management of resistant hypertension.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

28.

SFE/SFHTA/AFCE consensus on primary aldosteronism, part 7: Medical treatment of primary aldosteronism.

Author: Pechère-BertschiAntoinette, HerpinDaniel, LefebvreHervé

Treat primary aldosteronism
Side effects

This study reviewed the medical treatment of primary aldosteronism (PA), a condition characterized by excessive aldosterone production. Spironolactone, a potent mineralocorticoid receptor antagonist, is the first-line treatment, but may have side effects. In case of intolerance, amiloride or eplerenone may be used. Medical treatment of bilateral PA appears to be as efficient as surgical treatment for lateralized PA.

Consensus Development ConferenceA conference organized by the National Institutes of Health (NIH) to develop consensus and recommendations on medical issues.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Practice GuidelineGuidelines and recommendations for the diagnosis and treatment of specific medical conditions in medical practice.

Language : English

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