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All about: Inspra

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Generic name: Eplerenone
Brand names: Inspra

Why is Inspra prescribed?

Inspra is prescribed to improve survival in patients who have congestive heart failure and left ventricular systolic dysfunction following a heart attack. It is also used to treat high blood pressure. Inspra may be used alone or with other antihypertensive agents. Inspra lowers blood pressure by blocking the actions of the hormone aldosterone.

Most important fact about Inspra

Inspra can increase the levels of potassium in your blood, resulting in a potentially serious condition called "hyperkalemia." Your doctor will order periodic blood tests to check the amount of potassium in your blood. Be sure to avoid potassium supplements and salt substitutes that contain potassium. Make sure your doctor knows about every medication you are taking. Call your doctor immediately if you experience nausea, diarrhea, or weakness, as these may be signs of hyperkalemia.

How should you take Inspra?

Take Inspra exactly as prescribed; higher-than-recommended doses provide no additional benefit. Inspra may be taken with or without food.

--If you miss a dose...

Take the forgotten dose as soon as you remember. However, if it is almost time for your next dose, skip the one you missed and return to your regular schedule. Do not take two doses at once.

--Storage instructions...

Store at room temperature.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe to continue using Inspra.

  • More common side effects may include:
    Chest pain, dizziness, headache, high cholesterol and triglyceride levels, increased blood potassium level, increased risk for heart attack, kidney problems

This side effects list is not complete. If you have any questions about side effects you should consult your doctor. Report any new or continuing symptoms to your doctor right away.

Why should Inspra not be prescribed?

If your doctor determines that you have high blood potassium levels or severe kidney impairment, you cannot take Inspra. You must also avoid Inspra if you are taking certain medications that affect the liver (see "Possible food and drug interactions when taking Inspra").

You cannot take Inspra for high blood pressure if you also take potassium-sparing diuretics such as amiloride (Moduretic), spironolactone (Aldactone), and triamterene (Dyazide, Dyrenium, Maxide). Likewise, Inspra cannot be used to treat high blood pressure if you have type 2 diabetes along with high protein levels in the urine (known as microalbuminuria), a condition that could signal kidney problems.

Special warnings about Inspra

Inspra could cause potentially dangerous increases of blood potassium levels. Your doctor will monitor you closely to guard against this problem, especially if you also have diabetes or mild kidney or liver problems.

Use Inspra with caution if you have severe liver impairment. The drug's safety has not been studied in such people.

In clinical studies, Inspra did not appear to benefit people 75 years and older who were being treated for congestive heart failure following a heart attack. However, when treated for high blood pressure, those 65 and older experienced the same benefits as younger people.

Possible food and drug interactions when taking Inspra

Be sure to check with your doctor about the medications that should never be taken with Inspra, including:

Clarithromycin (Biaxin)
Itraconazole (Sporanox)
Ketoconazole (Nizoral)
Nefazodone (Serzone)
Nelfinavir (Viracept)
Ritonavir (Norvir)
Troleandomycin (Tao)

You should never take Inspra for high blood pressure if you're also taking potassium-sparing diuretics, including:

Amiloride (Moduretic)
Spironolactone (Aldactone)
Triamterene (Dyazide, Dyrenium, Maxide)

If Inspra is taken with certain other drugs, the effects of either drug could be increased, decreased, or altered. It is especially important to check with your doctor before combining Inspra with the following:

Blood pressure drugs known as ACE inhibitors, such as Prinivil and Zestril
Blood pressure drugs known as angiotensin II receptor antagonists, such as Avapro, Cozaar, and Diovan
Erythromycin (Ery-Tab)
Fluconazole (Diflucan)
Lithium (Eskalith, Lithobid, Lithonate)
Nonsteroidal anti-inflammatory drugs such as Motrin or Advil
Potassium supplements including K-Tabs, K-Dur, and Slow-K
Saquinavir (Invirase)
Verapamil (Calan, Isoptin)

You should also consult your doctor before using salt substitutes that contain potassium.

Special information if you are pregnant or breastfeeding

The effects of Inspra during pregnancy have not been adequately studied. If you are pregnant or planning to become pregnant, inform your doctor immediately.

It is not known whether Inspra appears in human breast milk. If Inspra is essential to your health, your doctor may advise you to stop nursing until your treatment is finished.

Recommended dosage


Congestive heart failure after a heart attack

The recommended daily dose is 50 milligrams. Your doctor will start you at 25 milligrams once a day and gradually increase the dose to 50 milligrams once a day over a period of 4 weeks.

Your doctor will test your blood potassium levels during the first week of treatment and again after 1 month. Depending on the results, the doctor may change your dosage and continue monitoring your potassium levels.

High blood pressure

The recommended starting dose is 50 milligrams once a day. Based on your response, the doctor may increase the dose to a maximum of 50 milligrams twice a day. If you're taking certain drugs that affect the liver, the doctor may start you at a dose of 25 milligrams once a day.


No cases of overdose have been reported. However, any medication taken in excess can have serious consequences. If you suspect an overdose, seek emergency treatment immediately.

  • The most likely symptoms of an Inspra overdose may include:
    Dizziness, diarrhea, feeling faint or light-headed, nausea, weakness

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