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Overview: Eplerenone is a medicine taken by mouth for certain heart problems or for high blood pressure. It helps your body get rid of extra salt and water. The most common side effect is high potassium levels in your blood. This can sometimes be serious. Call your health care provider right away if you have muscle weakness, unusual tiredness, abnormal heart rhythm or trouble breathing. Keep all of your appointments with your health care provider while taking eplerenone so your potassium levels can be monitored. Be sure to let your health care provider know about all of your health conditions and any medicines you take before taking eplerenone. 

Uses

What is eplerenone used for?

Eplerenone (Inspra) is commonly used to treat high blood pressure and heart failure after a heart attack. 

Eplerenone may also be used for other conditions as determined by your health care provider.

How does eplerenone work (mechanism of action)?

Eplerenone works by blocking a hormone called aldosterone in your body. Aldosterone causes your body to retain sodium and water, which can increase blood pressure. Blocking aldosterone helps decrease the amount of sodium and water the body retains.

How is eplerenone supplied (dosage forms)?

Brands and other names

  • Inspra

Dosage forms and strengths

  • 25 mg oral tablets
  • 50 mg oral tablets

How should I store eplerenone?

Eplerenone should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place.

Side Effects

What are the most common side effects of eplerenone?

The most common side effects of eplerenone are listed below. Tell your health care provider if you have any of these side effects that bother you.

There may be other side effects of eplerenone that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of eplerenone?

While less common, the most serious side effects of eplerenone are described below, along with what to do if they happen.

Severe Allergic Reactions. Eplerenone may cause allergic reactions, which can be serious. Stop taking eplerenone and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching or skin rash
  • Bumps on the skin called hives that can be red, pink, white, or brown depending on your skin tone
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

High Potassium Level (Hyperkalemia). Eplerenone can cause a high potassium level (hyperkalemia), which can be serious and may lead to death. Your health care provider will check your potassium levels, especially if you take certain other medicines. Call your health care provider if you have any of the following symptoms of a high potassium level. 

  • Muscle weakness or unusual tiredness
  • Slow heartbeat or feeling of skipped heartbeats 
  • Nausea or vomiting
  • Trouble breathing
  • Abnormal heart rhythm

Warnings & Precautions

Who should not use eplerenone?

Allergies to Ingredients. People who are allergic to any of the following should not use eplerenone products.

  • Eplerenone
  • Inspra
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific eplerenone products they stock.

Drug Interactions. Eplerenone should not be taken while you are using certain other medicines. Before taking eplerenone, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section below for more details.

High Potassium Levels. Eplerenone should not be taken if you have high potassium levels in your blood. Your health care provider may do tests to check your potassium levels to know if it is safe for you to take this medicine. 

Kidney Problems. Eplerenone should not be taken if your kidneys are not working as well as they should be. If there is a concern about your kidney function, your health care provider may do tests to see if they are working well enough to take this medicine.

What should I know about eplerenone before using it?

Do not take eplerenone unless it has been prescribed to you by a health care provider. Take it as prescribed.

Do not share eplerenone with other people, even if they have the same condition as you. It may harm them.

Keep eplerenone out of the reach of children.

People who are 65 or older can be at greater risk for some side effects from eplerenone. Talk to your health care provider about your risks if you are in this age group.

What should I tell my health care provider before using eplerenone?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if eplerenone is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

  • Kidney problems
  • Diabetes with increased protein levels in the urine (pee)
  • High potassium levels in the blood

Other Medicines and Supplements. Eplerenone may interact with other medicines and supplements. Before taking eplerenone, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section below for more details.

Pregnancy. It is not known if or how eplerenone could affect pregnancy or harm an unborn baby. Tell your health care provider if you are or plan to become pregnant.

Breastfeeding. It is not known if eplerenone passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will let you know if you should take eplerenone while breastfeeding.

Interactions

Does eplerenone interact with foods or drinks?

Grapefruit may increase the amount of eplerenone in your body and the risk of side effects.

It is unknown if drinking alcohol will affect eplerenone, but alcohol may increase potassium levels and increase the risk of this side effect from eplerenone. 

Does eplerenone interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking eplerenone.

  • Potassium supplements
  • A diuretic, also called a water pill, which is a medicine used to reduce edema (fluid retention) and blood pressure
  • An angiotensin-converting enzyme (ACE) inhibitor, which is a medicine for high blood pressure, heart failure, and certain kidney problems
  • An angiotensin II receptor blocker (ARB), which is a medicine for high blood pressure, heart failure, and other heart conditions
  • Lithium, which is a medicine used for mood disorders like bipolar disorder
  • A nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen, naproxen, and others, which are present in many prescription and OTC products for pain, swelling, and fever

Some other medicines may alter the blood levels of eplerenone. Tell your health care provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with eplerenone. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much eplerenone?

If you or someone else has used too much eplerenone, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of eplerenone?

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.