Eplerenone (Inspira, Pfizer) blocks binding of aldosterone at the mineralcorticoid receptor. It is used to treat patients with congestive heart failure (CHF). One adverse effect is hyperkalemia, which may require a reduced dose or temporary discontinuation of therapy.
|
Serum Potassium |
Action |
|
< 5.0 mmol/L |
adjust dose up 1 level |
|
5.0 to 5.4 mmol/L |
no change in dose |
|
5.5 to 5.9 mmol/L |
adjust dose down 1 level |
|
>= 6.0 mmol/L |
withhold dose |
If the drug is withheld, then it can be restarted at level 1 once the serum potassium has fallen below 5.5 mmol/L
|
Level |
Dose |
|
3 |
50 mg per day |
|
2 |
25 mg per day |
|
1 |
25 mg every other day |
|
0 |
withhold |
|
Initial |
withhold |
down 1 level |
no change |
up 1 level |
|
0 |
0 |
0 |
0 |
1 |
|
1 |
0 |
0 |
1 |
2 |
|
2 |
0 |
1 |
2 |
3 |
|
3 |
0 |
2 |
3 |
3 |
Purpose: To adjust the dose of eplerenone in a patient with congestive heart failure (CHF) based on the serum potassium.
Specialty: Pharmacology, clinical, Cardiology
Objective: dosage adjustments, response to therapy, adverse effects, overdose and reversal
ICD-10: I50.0,
