Eplerenone, Oral

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KEY POINTS

• This medicine taken by mouth to treat high blood pressure. It is also used to treat heart failure after a heart attack. Take it exactly as directed.
• This medicine can increase the potassium levels in your blood. Discuss this with your healthcare provider so that you do not get too much potassium.
• Keep all appointments for tests to see how this medicine affects you.
• This medicine may cause unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

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What are other names for this medicine?

Type of medicine: antihypertensive

Generic and brand names: eplerenone, oral; Inspra

What is this medicine used for?

This medicine taken by mouth to treat high blood pressure. It is also used to treat heart failure after a heart attack. It may be taken alone or along with other medicines.

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Tell your healthcare provider if you have ever had:

• An allergic reaction to any medicine
• Diabetes
• Heart problems
• High levels of potassium in the blood
• Liver or kidney disease

Before taking this medicine, tell your provider about all of the medicines and supplements you take. This medicine interacts with many medicines and supplements and this can cause serious harmful effects. Do not take any new medicines, even cold medicines or vitamins, unless you talk with your pharmacist or healthcare provider first.

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I take it?

Check the label on the medicine for directions about your specific dose. Take this medicine exactly as your healthcare provider prescribes. You must take this medicine regularly to control your blood pressure. Do not stop taking this medicine without your healthcare provider's approval. You may need to take this medicine for a long time even though you do not feel sick.

Check with your healthcare provider before using this medicine in children under age 17.

You may take this medicine with or without food. Taking it with meals may lessen the chance the drug will upset your stomach.

You need to watch your diet and follow a regular exercise program to help lower your blood pressure. Follow your healthcare provider's directions.

What if I miss a dose?

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: severe dizziness, fainting, vomiting, diarrhea, fast or irregular heartbeat, tremors, seizures.

What should I watch out for?

This medicine can increase the potassium levels in your blood. Do not take a potassium supplement or use salt substitutes while you are taking this medicine. You may need to avoid or limit foods that are high in potassium such as bananas, coconuts, dates, figs, prunes, apricots, peaches, tomato juice, and orange juice. Discuss this with your healthcare provider so that you do not get too much potassium.

Your healthcare provider will need to see you regularly to check your blood pressure and adjust your dosage as needed. You need to have blood tests regularly to see how this medicine affects you. Keep all appointments.

This medicine may make you dizzy. Drinking alcohol may make this worse. Do not drink alcohol unless your healthcare provider approves. Do not drive or operate machinery unless you are fully alert.

Adults over the age of 65 may be at greater risk for side effects. Talk with your healthcare provider about this.

If you need emergency care, surgery, lab tests, or dental work, tell the healthcare provider or dentist you are taking this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat).

Serious (Report these to your healthcare provider right away.): Irregular or fast heartbeat; chest pain; severe dizziness; fainting; sudden swelling or weight gain; numbness or tingling in the hands, feet, or lips; unexplained fever; muscle aches and pains; confusion; severe weakness or tiredness; diarrhea; trouble urinating or decreased urination; vomiting; trouble breathing.

Other: Headache, dizziness, mild tiredness, abnormal vaginal bleeding, cough, mild stomach pain, breast tenderness.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• ACE inhibitors such as benazepril (Lotensin), captopril, enalapril (Vasotec), fosinopril, lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), and trandolapril (Mavik)
• Aliskiren (Tekturna) and aliskiren/hydrochlorothiazide (Tekturna HCT)
• Alpha blockers such as alfuzosin (Uroxatral), doxazosin (Cardura), prazosin (Minipress), tamsulosin (Flomax), and terazosin
• Angiotensin receptor blockers (ARBs) such as azilsartan (Edarbi), candesartan (Atacand), eprosartan (Teveten), irbesartan (Avapro), losartan (Cozaar), olmesartan (Benicar), telmisartan (Micardis), and valsartan (Diovan)
• Antibiotics such as clarithromycin (Biaxin), erythromycin (E.E.S., Ery-Tab, Erythrocin), nitrofurantoin (Furadantin, Macrobid, Macrodantin), rifabutin (Mycobutin), rifampin (Rifadin), rifapentine (Priftin), and telithromycin (Ketek)
• Antidepressants such as desipramine (Norpramin) and nefazodone
• Antifungal medicines such as fluconazole (Diflucan), isavuconazonium (Cresemba), itraconazole (Sporanox), ketoconazole (Nizoral), posaconazole (Noxafil), and voriconazole (Vfend)
• Antipsychotic medicines such as aripiprazole (Abilify), asenapine (Saphris), clozapine (Clozaril, FazaClo), iloperidone (Fanapt), olanzapine (Zyprexa), paliperidone (Invega), quetiapine (Seroquel), risperidone (Risperdal), and ziprasidone (Geodon)
• Antiseizure medicines such as carbamazepine (Carbatrol, Epitol, Equetro, Tegretol), fosphenytoin (Cerebyx), phenytoin (Dilantin, Phenytek), and primidone (Mysoline)
• Antiviral medicines such as ombitasvir/paritaprevir/ritonavir/dasabuvir (Viekira) and ombitasvir/paritaprevir/ritonavir (Technivie)
• Barbiturates such as butabarbital (Butisol), pentobarbital (Nembutal), phenobarbital, and secobarbital (Seconal)
• Beta blockers such as acebutolol (Sectral), atenolol (Tenormin), carvedilol (Coreg), labetalol (Trandate), metoprolol (Lopressor, Toprol), nadolol (Corgard), pindolol, and sotalol (Betapace, Sorine)
• Bosentan (Tracleer)
• Calcium channel blockers such as diltiazem (Cardizem, Cartia, Tiazac), nicardipine (Cardene), nifedipine (Adalat CC, Procardia), and verapamil (Calan, Covera, Verelan)
• Cancer medicines such as ceritinib (Zykadia), crizotinib (Xalkori), enzalutamide (Xtandi), idelalisib (Zydelig), imatinib (Gleevec), mitotane (Lysodren), nilotinib (Tasigna), and obinutuzumab (Gazyva)
• Conivaptan (Vaprisol)
• Diuretics (water pills) such as amiloride, spironolactone (Aldactone), and triamterene (Dyrenium)
• Erectile dysfunction medicines such as avanafil (Stendra), sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra, Staxyn)
• HIV medicines such as atazanavir (Reyataz), darunavir (Prezista), efavirenz (Sustiva), elvitegravir/cobicistat/emtricitabine/tenofovir (Stribild), fosamprenavir (Lexiva), indinavir (Crixivan), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), ritonavir (Norvir), and saquinavir (Invirase)
• Immunosuppressants such as cyclosporine (Gengraf, Neoral, Sandimmune) and tacrolimus (Astagraf, Prograf, Protopic)
• Lithium (Lithobid)
• Lumacaftor/ivacaftor (Orkambi)
• Medicines to treat or prevent blood clots such as dalteparin (Fragmin), enoxaparin (Lovenox), and heparin
• Mifepristone (Korlym, Mifeprex)
• Modafinil (Provigil)
• Natural remedies such as bayberry, black cohosh, blue cohosh, California poppy, dong quai, ephedra, ginger, ginseng, goldenseal, gotu kola, hawthorn, kava, licorice, shepherd’s purse, St. John's wort, valerian, and yohimbe
• Nausea medicines such as aprepitant (Emend) and netupitant/palonosetron (Akynzeo)
• Nonsteroidal anti-inflammatory medicines (NSAIDs) such as diclofenac (Cambia, Voltaren, Zipsor), ibuprofen (Advil, Motrin), indomethacin (Indocin), ketoprofen, ketorolac, nabumetone (Relafen), naproxen (Aleve, Anaprox, Naprelan), oxaprozin (Daypro), piroxicam (Feldene), and sulindac (Clinoril)
• Other heart medicines such as digoxin (Lanoxin), dronedarone (Multaq), and quinidine
• Pain medicines such as buprenorphine (Buprenex, Butrans), fentanyl (Abstral, Actiq, Duragesic, Fentora, Sublimaze), methadone (Dolophine, Methadose), morphine, and oxycodone (OxyContin, Roxicodone)
• Potassium supplements or salt substitutes that contain potassium
• Propranolol (Hemangeol, Inderal, InnoPran)

Do NOT eat or drink products that contain grapefruit, Seville oranges, and tangelos at any time while you are taking this medicine. These fruits and juices affect the way this medicine works and increase your risk of serious side effects. Talk with your healthcare provider or pharmacist about this.

Do not drink alcohol while taking this medicine.

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicines in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.