Exinia Tablet
Eplerenone
25mg
RPG Life Sciences Ltd.
| Pack size | 1 |
|---|---|
| Dispensing mode | |
| Source | |
| Agent | |
| Retail Price | 26.59 NPR |
Available as:
Indications
Exinia Tablet is used for:
Hypertension, Heart failure, Congestive heart failure, Left ventricular dysfunction, Acute myocardial infarction
Adult Dose
Hypertension (HTN)
Initial 50 mg PO qDay; may increase to 50 mg PO q12hr; may take up to four weeks for full therapeutic response; hyperkelemia may occur with doses >100 mg/day
Heart Failure Post MI
Initial 25 mg PO qDay; may titrate to maximum of 50 mg once daily within 4 weeks as tolerated
Dose adjustments may be required based on potassium levels
Hepatic Impairment
Dose adjustment not necessary
Child Dose
Renal Dose
Renal Impairment
Contraindicated if CrCl <50 mL/min or serum creatinine >2 mg/dL in males or >1.8 mg/dL in females
Administration
May be taken with or without food.
Contra Indications
For all patients: Serum potassium >5.5 mEq/L at initiation; CrCl ?30 mL/min; concomitant use of strong CYP3A4 inhibitors (e.g. ketoconazole, itraconazole, nefazodone, troleandomycin, clarithromycin, ritonavir, nelfinavir). For patients treated for hypertension: Patients with type 2 DM with microalbuminuria; serum creatinine >2 mg/dL (male), or >1.8 mg/dL (female); CrCl <50 mL/min; concomitant use of potassium supplements or potassium-sparing diuretics (e.g. amiloride, spironolactone, or triamterene).
Precautions
Measure serum potassium levels before starting therapy, within the first wk, and periodically thereafter. Increased risk of hyperkalaemia in patients with impaired renal functions; diabetic patients with CHF post-MI (especially those with proteinuria); or concurrent use of agents affecting the rennin-angiotensin-aldosterone system. Safety and efficacy not established in patients with severe hepatic impairment; or paediatric patients <18 yr. Elderly. Pregnancy and lactation.
Lactation: unknown if excreted into breast milk, discontinue drug or nursing
Pregnancy-Lactation
Interactions
Concomitant use with CYP3A4 Inhibitors (e.g. ketoconazole, voriconazole, itraconazole, fluconazole, clarithromycin, diltiazem saquinavir, verpamil, ritonavir) may increase serum concentrations of Eplerenone. CYP3A4 inducers (e.g. rifampicin, carbamazepine, phenytoin, phenobarbital) may decrease Eplerenone efficacy. Eplerenone may enhance hyperkalaemic effect of ACE inhibitors, angiotensin II receptor blockers, potassium-sparing diuretics or potassium salts. Concomitant use with diazoxide, MAOIs, pentoxifylline, prostacyclin analogues may enhance hypotensive effect of antihypertensives.
NSAIDs may possibly reduce the antihypertensive and/or diuretic effects of potassium-sparing diuretics and may increase risk of hyperkalaemia. Lithium toxicity has been reported when used with ACE inhibitors or diuretics; monitor lithium levels when used with Eplerenone.
Adverse Effects
Side effects of Eplerenone :
1-10%
Hyperkalemia (2-10%),Increased risk of hyperkalemia with presence of renal dysfunction
1-3%
Dizziness,Fatigue/malaise,Abdominal pain,Diarrhea,Albuminuria,Hypercholesterolemia,Hypertriglyceridemia,Cough
<1%
Abnormal vaginal bleeding,Gynecomastia,Mastodynia
Mechanism of Action
Aldosterone binds to mineralocorticoid receptors in both epithelial (e.g. kidney, GI tract) and nonepithelial (e.g. heart, blood vessels, brain) tissues; causing increases in blood pressure by inducing sodium reabsorption, vascular remodeling, water retention and possibly other mechanisms. Eplerenone is a relatively selective mineralocorticoid receptor antagonist, blocking binding of aldosterone and reducing blood pressure. Eplerenone also appears to have cardioprotective effect in patients with congestive heart failure (CHF) after myocardial infarction (MI).
Note
Exinia 25mg Tablet manufactured by RPG Life Sciences Ltd.. Its generic name is Eplerenone. Exinia is availble in Nepal.
Farmaco Nepal drug index information on Exinia Tablet is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.