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Inspra
Inspra (generic name: eplerenone) is a medication primarily used to treat high blood pressure (hypertension) and to reduce the risk of cardiovascular events in patients with chronic heart failure. It is classified as an aldosterone antagonist and works by blocking the effects of aldosterone, a hormone that contributes to sodium retention, potassium excretion, and increased blood pressure. By inhibiting aldosterone, Inspra helps promote the excretion of sodium and water, leading to lower blood pressure.
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Frequently Asked Questions
How long does it take for Inspra to work?
Patients may start to see improvements in blood pressure within a few days, but optimal effects may take several weeks to fully develop.
Can Inspra be taken during pregnancy?
Inspra should be used during pregnancy only if the benefits outweigh the risks. Consult your healthcare provider for personalized advice.
What should I do if I miss a dose of Inspra?
If you miss a dose, take it as soon as you remember. If it is close to the time for your next dose, skip the missed dose and continue with your regular schedule. Do not double up on doses.
Are there any dietary restrictions while taking Inspra?
There are no specific dietary restrictions, but monitoring potassium intake is advisable, particularly for those at risk of hyperkalemia.
Is Inspra safe for long-term use?
Inspra can be safe for long-term use under the supervision of a healthcare provider, with regular monitoring for potential side effects and effectiveness in managing hypertension and heart failure.
Comprehensive Drug Guide
How Does Inspra Work?
- Blocking aldosterone receptors: Eplerenone selectively inhibits aldosterone from binding to its receptors in the kidneys, heart, and blood vessels.
- Promoting diuresis: This action increases the excretion of sodium and water while conserving potassium, ultimately leading to reduced blood volume and lower blood pressure.
Common Dosages
- Inspra: 25 mg or 50 mg tablets, with the initial dose usually starting at 50 mg once daily.
Typical Dosing
- For hypertension: The usual starting dose is 50 mg once daily, which may be adjusted based on blood pressure response and tolerance. The maximum recommended dose is 100 mg per day.
- For heart failure: Start with 25 mg once daily, which may be increased to 50 mg once daily based on renal function and potassium levels.
Typical Dosing
FDA Approved Indications
- Treatment of hypertension in adults.
- Reduction of the risk of cardiovascular mortality and morbidity in patients with chronic heart failure following a myocardial infarction.
Who Shouldn't Take Inspra?
- Known hypersensitivity to eplerenone or any components of the formulation.
- Significant renal impairment (eGFR < 30 mL/min).
- Hyperkalemia (high potassium levels).
Advice From The Pharmacist
- Take Inspra once daily, with or without food, but it’s advisable to take it at the same time each day for consistency.
- Regular monitoring of blood pressure, renal function, and potassium levels is essential, especially during the initiation of therapy or after any dose adjustments.
- Be aware of signs of high potassium levels (e.g., muscle weakness, irregular heartbeat) and report any concerns to your healthcare provider.
Side Effects of Inspra
Common Side Effects
- Dizziness
- Fatigue
- Headache
- Diarrhea
Uncommon/Severe Side Effects
- Hyperkalemia (high potassium levels), which can lead to cardiac arrhythmias.
- Severe allergic reactions (rash, itching, swelling, difficulty breathing).
Risks and Warnings of Inspra
- Hyperkalemia: Patients should be monitored for elevated potassium levels, particularly those with renal impairment or those taking other medications that may increase potassium.
- Renal Function: Regular monitoring of renal function is important, especially during the initiation of treatment.
- Caution in Heart Failure: Eplerenone is contraindicated in patients with severe renal impairment or significant electrolyte imbalances.
Interactions with Inspra
Common Drug Interactions
- Other potassium-sparing diuretics: Concurrent use with eplerenone can increase the risk of hyperkalemia.
- ACE inhibitors and ARBs: Caution should be exercised when combining these medications with Inspra, as they can also increase potassium levels.
- CYP3A4 inhibitors: Eplerenone is metabolized by CYP3A4, so strong inhibitors of this enzyme may increase its levels, leading to potential side effects.
Alternatives to Inspra
- Spironolactone: Another aldosterone antagonist that is used for similar indications but may have different side effect profiles.
- ACE inhibitors: Such as lisinopril or ramipril, which are also used in hypertension and heart failure.
- Calcium channel blockers: Such as amlodipine, which may be considered for blood pressure control.
