Details
Inspra Indications
Addition to standard treatment with .beta.-blockers to reduce the risk of morbidity and mortality associated with cardiovascular diseases, in stable patients with left ventricular dysfunction (left ventricular ejection fraction ≤40%) and clinical evidence of heart failure after recent myocardial infarction.
Addition to standard optimal therapy to reduce the risk of morbidity and mortality associated with cardiovascular disease, in adult patients with heart failure class II (chronic) in NYHA classification, and left ventricular dysfunction (left ventricular ejection fraction ≤30%) (see. section Pharmacodynamics).
Dosage & Administration
Inspra drug exists in doses of 25 mg and 50 mg. The maximum daily dose is 50 mg.
Eplerenone can be taken with food or without food.
Patients with heart failure after myocardial infarction. The recommended maintenance dose of eplerenone is 50 mg 1 time per day. Treatment should be initiated at a dose of 25 mg 1 time per day and gradually increase to the target dose of 50 mg 1 time per day. It is desirable to achieve the target dose for 4 weeks, taking into account the level of potassium in the blood plasma. eplerenone treatment is usually necessary to begin in 3-14 days after an acute myocardial infarction.
Patients with heart failure class II (chronic) in NYHA classification
Treatment of patients with chronic heart failure NYHA class II classification should be started at a dose of 25 mg 1 time per day and gradually increase to the target dose of 50 mg 1 time per day. It is desirable to achieve the target dose for 4 weeks, taking into account the level of potassium in the blood plasma.
Patients whose plasma potassium levels greater than 5 mmol / L should not start treatment eplerenone.
Potassium levels in plasma should be determined before treatment eplerenone, during the first week of treatment and one month after the start of treatment or dose adjustment. If necessary, periodically determine the potassium level in blood plasma during treatment.
After initiation of treatment dose should be adjusted to the blood plasma concentration of potassium.
Contradictions
Hypersensitivity to eplerenone or any of the excipients. The level of potassium in the blood plasma of> 5 mmol / l at the start of treatment. Severe renal insufficiency (estimated glomerular filtration rate <30 mL / min / 1.73 m2). Hepatic failure, severe (class C Child-Pugh classification).
Treatment of potassium-sparing diuretics, potassium-supplements or strong inhibitors of CYP 3A4 (eg itraconazole, ketoconazole, ritonavir, nelfinavir, clarithromycin, telithromycin and nefazodone). Concomitant use of eplerenone in triple combination with ACE inhibitors and angiotensin receptor blockers.