Which medications in the drug class Aldosterone Antagonists, Selective are used in the treatment of Hypertension?

Updated: Feb 22, 2019
  • Author: Matthew R Alexander, MD, PhD; Chief Editor: Eric H Yang, MD  more...
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Aldosterone Antagonists, Selective

Aldosterone antagonists compete with aldosterone receptor sites, reducing blood pressure and sodium reabsorption.

Eplerenone (Inspra)

Eplerenone selectively blocks aldosterone at the mineralocorticoid receptors in epithelial (eg, kidney) and nonepithelial (eg, heart, blood vessels, brain) tissues, thus decreasing BP and sodium reabsorption. Although this agent is more specific than spironolactone at the mineralocorticoid receptor, it is less potent. There have also been some minimal reports of gynecomastia.

Eplerenone is indicated for the treatment of hypertension. Eplerenone may be used alone or in combination with other antihypertensive agents.


Spironolactone is usually used in combination with other drugs for patients who cannot be treated adequately with other agents or for whom other agents are considered inappropriate. The initial dose ranges from 50-100 mg daily in single or divided doses. Spironolactone can cause hyperkalemia; therefore, potassium supplementation should not be given concurrently. Other adverse effects include gynecomastia and impotence, which often mitigates the use of spironolactone in younger men.

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