Eplerenone is a blood pressure medicine

It’s used to treat heart failure and reduce the risk of you having other heart problems or a stroke. It also helps to stop heart failure getting worse.

It can sometimes be used to treat a condition called hyperaldosteronism. This is when your body makes too much aldosterone, a hormone that controls your blood pressure.

Eplerenone comes as tablets and is only available on prescription.

You will normally take it with other blood pressure medicines.

• Eplerenone works by lowering your blood pressure. This makes it easier for your heart to pump blood around your body.
• You’ll usually take eplerenone once a day. If you’re bothered by side effects your doctor may tell you to take it every other day.
• Taking eplerenone can raise the levels of potassium in your blood. You will have regular blood tests to check your potassium.
• Having too much potassium can give you muscle cramps and diarrhoea. Do not take extra potassium without talking to your doctor.
• It’s important to keep taking eplerenone even if you feel well. You’ll still be getting the benefits of the medicine.

Eplerenone can be taken by most adults aged 18 years and over.

Eplerenone is not suitable for some people. To make sure it’s safe for you, tell your doctor before starting eplerenone if you have:

• ever had an allergic reaction to eplerenone or other medicine
• liver or kidney disease
• type 2 diabetes
• been told you have high levels of potassium in your blood (you will also have a blood test before starting eplerenone to check for this)

It is important to take eplerenone exactly as your doctor has told you.

You’ll usually take eplerenone once a day. You can choose a time that suits you, but try to take it at the same time every day. This will make it easier to remember to take your medicine.

Swallow the tablets whole with water. You can take eplerenone with or without food.

Dosage

Eplerenone comes as 25mg and 50mg tablets.

The usual starting dose is 25mg once a day and your doctor may increase it to 50mg once a day.

Your dose may change depending on the level of potassium in your blood. If your blood test shows you have too much potassium in your blood your doctor may reduce the dose. Or they may ask you to stop taking eplerenone for a short time.

What if I forget to take it?

If you forget to take a dose of eplerenone, take it as soon as you remember on that day and then carry on as normal the next day.

If you forget to take the dose for the whole day, skip the missed dose and carry on as normal the next day. Do not take a double dose to make up for a forgotten one.

If you forget doses often, it may help to set an alarm to remind you, or you could ask your pharmacist for advice on other ways to help you remember to take your medicine.

What if I take too much?

Like all medicines eplerenone can cause side effects, although not everyone gets them.

Side effects often improve as your body gets used to the medicine.

Common side effects

These common side effects happen in more than 1 in 100 people. They’re usually mild and do not last long.

These are not all the side effects of eplerenone. For a full list, see the leaflet inside your medicine packet.

What to do about:

• feeling dizzy – if eplerenone makes you feel dizzy, stop what you’re doing and sit or lie down until you feel better. Do not drive, ride a bike or operate machinery. If the dizziness continues for more than a few days, speak to your doctor as you may need your potassium levels checked.
• headaches – make sure you rest and drink plenty of water or squash. Do not drink too much alcohol. Ask your pharmacist to recommend a painkiller. Talk to your doctor if the headaches last longer than a week or are severe.
• difficulty sleeping – avoid caffeine (tea, coffee, cola and chocolate) in the afternoon and evening. Keep your bedroom dark and quiet, and try going to bed at the same time each day. Stop watching TV and using electronic devices like mobiles or tablets at least 1 hour before bedtime.
• cough – sometimes the cough will get better on its own. Talk to your doctor if it carries on, bothers you, or stops you sleeping.

Eplerenone is not usually recommended in pregnancy.

If you’re trying to get pregnant or you’re already pregnant, talk to your doctor about the benefits and possible risks of taking eplerenone. There may be other medicines that are safer for you.

Eplerenone and breastfeeding

Eplerenone is not usually recommended while you’re breastfeeding. Small amounts of eplerenone may get into breast milk, but there isn’t enough research to know whether it is harmful for babies.

Your doctor may still recommend eplerenone, as it is important to treat your high blood pressure to keep you well. Breastfeeding will also benefit both you and your baby. Your baby may need extra monitoring while you take eplerenone.

Talk to your doctor or health visitor if your baby’s not feeding as well as usual or seems unusually sleepy, or if you have any other concerns.

There are some medicines that may affect the way eplerenone works. They could also make you more likely to have side effects.

Tell your doctor if you are taking any of these medicines before starting eplerenone:

• high blood pressure medicines like ramipril, enalapril, losartan or candesartan
• tacrolimus or ciclosporin, used to treat skin conditions such as psoriasis or eczema
• trimethoprim, an antibiotic for UTIs and other infections
• digoxin – used for heart conditions
• lithium – used to treat bipolar disorder
• non-steroidal anti-inflammatory drugs (NSAIDs) including ibuprofen
• medicines to treat fungal infections like itraconazole
• spironolactone or amiloride – medicines that affect your potassium levels
• warfarin – a blood thinning medicine

Mixing eplerenone with herbal remedies or supplements

St Johns wort, a herbal medicine taken for depression, can affect how eplerenone works. Talk to your doctor if you are using this or thinking about using it.

Do not take any potassium supplements including salt substitute tablets. Some multivitamin and mineral supplements may contain potassium. Always check the label.