Cardiology · Selective MRA
Eplerenone
Dose
25 mg OD, up-titrate to 50 mg OD after 4 weeks.
Mechanism
Selective aldosterone antagonist (no androgenic effect).
Indications
- • HFrEF post-MI (EPHESUS)
- • Chronic HF (EMPHASIS-HF)
- • Resistant HTN
Contraindications
- • K+ >5.0
- • CrCl <30
- • Strong CYP3A4 inhibitors
Use
MRA when spironolactone side-effects (gynaecomastia) limit use.
Monitoring
K+, U&E, BP.
Side effects
- • Hyperkalaemia
- • Hyponatraemia
- • Dizziness
Related in WardRound
Always confirm dose against your local formulary / BNF before prescribing.
