Common questions about eplerenone - Brand name: Inspra

Eplerenone is a type of medicine known as an aldosterone-blocking agent.

Aldosterone is a hormone that controls your blood pressure. It does this by changing the amount of water and salt kept in your body. Too much aldosterone can cause changes in your body that lead to or worsen heart failure.

Eplerenone works by blocking aldosterone, which helps:

• to improve your heart function
• with symptoms of heart failure
• to stop your heart failure getting worse

Once you start taking eplerenone, it usually takes up to 4 weeks to reach the full effect.

Carry on taking it even if you do not feel any different. The medicine will still be working.

You can take eplerenone for a long time, but you will have to see your doctor or nurse occasionally for blood tests. These tests make sure the minerals in your blood such as potassium are properly balanced.

How often you need to see your doctor or nurse for these tests will depend on the reason you're taking eplerenone, any recent changes to your dose, your age, and any other conditions, such as kidney or liver disease.

Talk to your doctor if you want to stop taking eplerenone. Stopping could make your heart failure worse.

If you want to stop because of side effects, your doctor may be able to prescribe a different medicine for you.

Taking eplerenone will help to stop your heart failure getting worse. This means you'll probably have to take it for the rest of your life.

The only other medicine similar to eplerenone is spironolactone.

Spironolactone stops aldosterone working in the same way as eplerenone, but it can also block some other hormones from working. This means that you may be more likely to get side effects with spironolactone.

Eplerenone will not stop your contraception working, but some types of hormonal contraception, like the combined pill and contraceptive patch, are not usually recommended if you have heart problems.

Talk to your doctor if you're taking a hormonal contraceptive.

If you have severe diarrhoea or eplerenone makes you sick (vomit), your contraceptive pills may not protect you from pregnancy. If this happens, follow the instructions in the leaflet that comes with your contraceptive pills.

Find out more:

• What to do if you're sick or have diarrhoea when taking the combined pill
• What to do if you're sick or have diarrhoea when taking the progestogen-only pill

Eplerenone can make some people feel dizzy or tired, especially when they first start taking it or after an increase in the dose. If this happens, do not drive a car or ride a bike until you feel better.

It might be best to stop driving and cycling for the first few days of treatment until you know how this medicine makes you feel.

It's an offence to drive a car if your ability to drive safely is affected. It's your responsibility to decide if it's safe to drive. If you're in any doubt, do not drive.

Talk to your doctor or pharmacist if you're unsure whether it's safe for you to drive while taking eplerenone. GOV.UK has more information on the law on drugs and driving.

It's a good idea not to drink alcohol when you first start taking eplerenone or after an increase in your dose, until you see how the medicine affects you.

Drinking alcohol can increase the blood pressure-lowering effect of eplerenone, which can make you feel dizzy or lightheaded.

Eplerenone can make some people feel dizzy. If this happens to you, try not to drink alcohol as it may make you feel worse.

It's best to avoid alcohol when you first start taking eplerenone.

Eating a healthy, balanced diet can help if you have high blood pressure or another heart condition.

Do not have low-sodium salt or salt substitutes, such as Lo-Salt, because they contain a lot of potassium. Using these with eplerenone can make your potassium levels too high.

Try to limit other food and drink that contains a lot of potassium, including bananas, avocados, pulses, nuts and salmon. Your doctor or dietitian can help you make a low potassium diet.

You can help the health of your heart by making some key lifestyle changes.

These will also help if you have high-blood pressure or heart failure.

• Quit smoking – smoking increases your heart rate and blood pressure. Quitting smoking brings down your blood pressure and relieves heart failure symptoms. Try to avoid second-hand smoke too.
• Cut down on alcohol – drinking too much alcohol raises blood pressure over time. It makes heart failure worse too. Try to keep to the recommended guidelines of no more than 14 units of alcohol a week.
• Exercise – regular exercise lowers blood pressure by keeping your heart and blood vessels in good condition. It does not need to be too energetic. Walking every day can help.
• Eat well – aim to eat a diet that includes plenty of fruit and vegetables, wholegrains, fat-free or low-fat dairy products and lean proteins.
• Eating too much salt is the biggest cause of high blood pressure. The more salt you eat, the higher your blood pressure will be. Aim for no more than 6g of salt a day. However, it's important not to go on a low-salt diet while taking this medicine. Talk to your doctor for advice.
• Manage stress – when you're anxious or upset, your heart beats faster, you breathe more heavily, and your blood pressure often goes up. This can make heart failure worse too. Find ways to reduce stress in your life. To give your heart a rest, try napping or putting your feet up when possible. Do things you enjoy with friends and family to be social and to help avoid stress.
• Vaccinations – if you have heart failure, it's recommended that you have the flu vaccine every year, and the pneumococcal vaccine and COVID-19 vaccine, as recommended by your GP. Ask your doctor about these vaccinations. You can have them free on the NHS if you have heart failure. Talk to your doctor if you think you might be in one of the at risk groups.