Aldosterone Antagonists in the Treatment of Heart Failure

Todd R. Marcy; Toni L. Ripley

Am J Health Syst Pharm. 2006;63(1):49-58.

Conclusion

Spironolactone and eplerenone are life-saving agents for patients with advanced heart failure and may benefit patients with mild heart failure. Patients' potassium levels and renal function must be routinely assessed to minimize the risk of life-threatening hyperkalemia.

1 2 3 4 5 6 7 8 9

Next Section

Reprint Address

Address correspondence to Dr. Marcy at the University of Oklahoma College of Pharmacy, P.O. Box 26901, Oklahoma City, OK 73190 ( todd-marcy@ouhsc.edu ).

Cite this: Aldosterone Antagonists in the Treatment of Heart Failure - Medscape - Jan 01, 2006.

Comparison of Spironolactone and Eplerenone
Variable^a	Spironolactone	Eplerenone
Pharmacology	Nonselective competitive aldosterone antagonist	Selective competitive aldosterone antagonist
Has active metabolites?	Yes	No
Half-life	1.4 hr^b	4–6 hr
Oral bioavailability	>90%	67%
Highly protein bound (>90%)	Yes	No
Metabolized by CYP isoenzyme system	No	Yes
Associated with gynecomastia?	Yes	No
Associated with adverse sexual effects?	Yes	No
Associated with adverse GI effects?	No	Yes
Cost for 30-day supply	Approximately $0.35/day (generic)^c	Approximately $3.75/day^c
Population showing benefit	Chronic, severe, systolic heart failure	Left ventricular systolic dysfunction immediately after MI

^aCYP = cytochrome P-450, GI = gastrointestinal, MI = myocardial infarction.
^bHalf-life of active metabolites is 14–22 hours.
^cAverage retail price based on prices obtained from two retail pharmacies.

processing....

Aldosterone Antagonists in the Treatment of Heart Failure

Conclusion

Tables

References

Authors and Disclosures

Authors and Disclosures

Email This

Feedback