Journal of Pharmacy And Bioallied Sciences

REVIEW ARTICLES
Year
: 2020  |  Volume : 12  |  Issue : 4  |  Page : 381--390

Eplerenone: The multifaceted drug in cardiovascular pharmacology


Akshyaya Pradhan, Shaweta Vohra, Rishi Sethi 
 Department of Cardiology, King George’s Medical University, Lucknow, Uttar Pradesh, India

Correspondence Address:
Dr. Akshyaya Pradhan
Department of Cardiology, King George’s Medical University,Lucknow 226003, Uttar Pradesh
India

Conventionally, rennin–angiotensin–aldosterone system (RAAS) inhibition has focused on angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers and angiotensin receptor-neprilysin inhibitors (ARNI) are the latest addition to this armamentarium. However, mineralocorticoid receptor antagonists (MRAs) also constitute an integral part of this anti-RAAS brigade, which are perceived more often as diuretics and are often under prescribed in heart failure (HF) despite being universally advocated by all major guidelines. Apart from HF, they have also shown promise in the management of hypertension, post-myocardial infarction, and hyperaldosteronism. Eplerenone, Food and Drug Administration (FDA) approved in 2002, is an acceptable alternative to spironolactone due to its sparing androgenic effects. In two big pivotal trials in heart failure (EMPHASIS -HF) and post-myocardial infarction (EPHESUS), the drug has firmly shown a reduction in adverse cardiovascular events. It has an established place in the management of resistant hypertension too. In this article, we will discuss the role of RAAS and its pathophysiology, pitfalls of spironolactone, which led to success of its congener, eplerenone, major studies conducted on eplerenone, current role of eplerenone, and comparison of the two MRAs.


How to cite this article:
Pradhan A, Vohra S, Sethi R. Eplerenone: The multifaceted drug in cardiovascular pharmacology.J Pharm Bioall Sci 2020;12:381-390


How to cite this URL:
Pradhan A, Vohra S, Sethi R. Eplerenone: The multifaceted drug in cardiovascular pharmacology. J Pharm Bioall Sci [serial online] 2020 [cited 2020 Oct 29 ];12:381-390
Available from: https://www.jpbsonline.org/article.asp?issn=0975-7406;year=2020;volume=12;issue=4;spage=381;epage=390;aulast=Pradhan;type=0