eplerenone
Brand names: Inspra
Eplerenone (Inspra) helps you live longer if you have heart failure after a heart attack. It also lowers blood pressure if you have high blood pressure.
Drug Pricing (NADAC)
Brand Price
$14.17/unit
Generic Price
$0.37/unit
Generic Savings
97%
Generic Available
Yes (5 manufacturers)
Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →
What it does
Eplerenone is used to help people with heart failure who have had a heart attack live longer.
Common side effects
High potassium levels in your blood, Increased creatinine levels
Key warnings
Eplerenone can cause high potassium levels in your blood, which can be dangerous.
How It Works
Eplerenone blocks a hormone called aldosterone in your body. Aldosterone can cause your body to hold onto too much salt and water, which can raise blood pressure and worsen heart failure. By blocking aldosterone, eplerenone helps lower blood pressure and reduce strain on the heart.
How to Take It
If you have heart failure, start with 25 mg once a day. Your doctor may increase this to 50 mg once a day within 4 weeks. If you have high blood pressure, take 50 mg once a day. If needed, your doctor may increase this to 50 mg twice a day. Always follow your doctor's instructions.
Pregnancy & Breastfeeding
It is not known if eplerenone can harm your unborn baby. Talk to your doctor if you are pregnant or plan to become pregnant. It is also not known if eplerenone passes into breast milk. Talk to your doctor about the best way to feed your baby if you are taking eplerenone.
Missed Dose
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and take your next dose at the regular time.
Storage
Store eplerenone at room temperature (between 59°F and 86°F).
Side Effects (from patient reports)
Based on 7,181 FDA adverse event reports.
FDA Adverse Event Report Analysis
Detailed analysis of 12,113 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2004–2025.
Total Reports
12,113
Death-Related Reports
1,200
Hospitalization Reports
6,337
Top Indication
Product Used For Unknown Indication
Gender Distribution
Age Distribution
Most Reported Adverse Reactions (FAERS)
| # | Reaction | Reports |
|---|---|---|
| 1 | DYSPNOEA | 1,083 |
| 2 | CARDIAC FAILURE | 939 |
| 3 | ACUTE KIDNEY INJURY | 905 |
| 4 | HYPOTENSION | 859 |
| 5 | FATIGUE | 659 |
| 6 | DIZZINESS | 650 |
| 7 | DIARRHOEA | 551 |
| 8 | DRUG INTERACTION | 529 |
| 9 | OEDEMA PERIPHERAL | 521 |
| 10 | NAUSEA | 487 |
| 11 | DRUG INEFFECTIVE | 475 |
| 12 | OFF LABEL USE | 447 |
| 13 | ASTHENIA | 437 |
| 14 | ATRIAL FIBRILLATION | 421 |
| 15 | FALL | 397 |
Reactions in Death Reports
Reactions in Hospitalization Reports
Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation
Serious Warnings
Eplerenone can cause high potassium levels in your blood, which can be dangerous. Your doctor will check your potassium levels before you start taking eplerenone and regularly while you are taking it. People with kidney problems, diabetes, or who take certain other medicines are at higher risk.
Known Drug Interactions
7 DRUG INTERACTIONS • CYP3A Inhibitors: In post-MI HFrEF patients, do not exceed 25 mg once daily when used with moderate CYP3A inhibitors (e.g., verapamil, erythromycin, saquinavir, fluconazole).
Mechanism: Fluconazole blocks the enzyme that clears eplerenone from your body, which can lead to higher levels of the drug in your blood.
What to do: Your doctor should lower your eplerenone dose to a maximum of 25 mg once daily.
7 DRUG INTERACTIONS • CYP3A Inhibitors: In post-MI HFrEF patients, do not exceed 25 mg once daily when used with moderate CYP3A inhibitors (e.g., verapamil, erythromycin, saquinavir, fluconazole).
Mechanism: Verapamil slows down the body's ability to process eplerenone, which can cause the drug to reach higher levels in your blood.
What to do: Your doctor should limit your eplerenone dose to 25 mg once daily when taking these together.
7 DRUG INTERACTIONS • CYP3A Inhibitors: In post-MI HFrEF patients, do not exceed 25 mg once daily when used with moderate CYP3A inhibitors (e.g., verapamil, erythromycin, saquinavir, fluconazole).
Mechanism: Erythromycin blocks the proteins that break down eplerenone, leading to more of the drug staying in your body.
What to do: If you are taking erythromycin, your daily dose of eplerenone should not exceed 25 mg.
Diuretics Eplerenone Finerenone Contraindicated during and 2 weeks after itraconazole treatment.
Mechanism: Itraconazole prevents your body from processing eplerenone, which can cause the diuretic to reach toxic levels in your blood.
What to do: This combination must be avoided during treatment and for two weeks after you stop taking itraconazole.
Cardiovascular agents eplerenone ↑ eplerenone Co-administration with eplerenone is contraindicated due to potential for hyperkalemia [see Contraindications (4) ] .
Mechanism: Nirmatrelvir/ritonavir raises the levels of eplerenone in your blood by slowing its breakdown. This can cause your potassium levels to become dangerously high.
What to do: This combination is contraindicated and should not be used.
Common Questions
Can I take eplerenone if I have kidney problems?
Can I take eplerenone if I have diabetes?
What should I do if I experience side effects?
Can I take eplerenone with other medications?
How long does it take for eplerenone to work?
Will eplerenone cure my condition?
Can I stop taking eplerenone if I feel better?
Does eplerenone have any effect on fertility?
What if my potassium level is too high?
Are there foods I should avoid while taking eplerenone?
What are the common side effects of eplerenone?
Does eplerenone interact with other medications?
What drug class is eplerenone?
Is there a generic version of eplerenone?
Is eplerenone safe during pregnancy?
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Medication Guides
Understanding Drug Interactions
How CYP450 enzymes, inhibitors, and inducers affect your medications
Generic vs Brand Name Drugs
FDA requirements, cost savings, and when the difference matters
Narrow Therapeutic Index Drugs
Why some drugs demand precise dosing and monitoring
Common Drug Interactions
Dangerous medication combinations and how to protect yourself
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What the FDA Data Shows for eplerenone
The FDA label for eplerenone (sold under brand names such as Inspra) classifies it as a prescription-only medication in the Aldosterone Antagonist class. Eplerenone is used to help people with heart failure who have had a heart attack live longer. Official labeling lists 2 commonly reported side effects, including High potassium levels in your blood, Increased creatinine levels.
Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 7,181 voluntary reports. The database also lists 12 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated major severity. NADAC pricing from CMS shows a generic unit cost of $0.37 versus $14.17 for the brand — a 97% generic savings.
Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.
Data Sources
Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).
FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.
Last updated: June 23, 2025
Read our methodology — how this data is sourced, computed, and verified.
All federal data sources used on this page
- FDA Orange Book — approved drug products with therapeutic equivalence. accessdata.fda.gov/cder/ob
- FDA DailyMed — NIH-hosted drug labeling for FDA-approved meds. dailymed.nlm.nih.gov
- FDA Adverse Event Reporting System (FAERS) — post-marketing safety surveillance. fda.gov/drugs/faers
- NLM RxNorm — standardized clinical drug nomenclature. nlm.nih.gov/research/umls/rxnorm
- CMS Medicare Part B Drug Average Sales Price Files — federal drug pricing data. cms.gov/medicare/part-b-drugs/asp
- FDA Drug Shortages Database — current and resolved drug shortage tracking. accessdata.fda.gov/drugshortages