{"id":51742,"date":"2023-09-20T09:24:57","date_gmt":"2023-09-20T09:24:57","guid":{"rendered":"https:\/\/medsname.com\/eptus\/"},"modified":"2026-05-01T10:49:11","modified_gmt":"2026-05-01T10:49:11","slug":"eptus","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/eptus\/","title":{"rendered":"Eptus"},"content":{"rendered":"<p><!-- medsbase-tldr-answer --><\/p>\n<div style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:18px 22px;margin:0 0 24px 0;border-radius:4px;\">\n<h3 class=\"wp-block-heading\" style=\"margin:0 0 8px 0;font-size:16px;font-weight:700;\">\u26a1 Rychl\u00e1 odpov\u011b\u010f \u2014 Co je Eptus?<\/h3>\n<p style=\"margin:0;\"><strong>Eptus<\/strong> je <strong>tableta eplerenonu 25 \/ 50 mg<\/strong> od spole\u010dnosti Sun Pharma \u2014 <strong>selektivn\u00ed antagonista mineralokortikoidn\u00edho receptoru<\/strong>. Eplerenon se od spironolaktonu li\u0161\u00ed svou <strong>mnohem vy\u0161\u0161\u00ed selektivitou pro MR<\/strong> oproti progesteronov\u00fdm a androgenn\u00edm receptor\u016fm \u2014 vyh\u00fdb\u00e1 se gynekomastii (5\u201310 % u spironolaktonu) a menstrua\u010dn\u00edm nepravidelnostem, za cenu m\u00edrn\u011b ni\u017e\u0161\u00ed \u00fa\u010dinnosti na MR a vy\u0161\u0161\u00ed ceny. Kl\u00ed\u010dov\u00e9 indikace: <strong>postinfarktov\u00e1 dysfunkce LV (EPHESUS 2003)<\/strong> \u2014 15% sn\u00ed\u017een\u00ed celkov\u00e9 mortality; <strong>m\u00edrn\u00e9 a\u017e st\u0159edn\u011b t\u011b\u017ek\u00e9 HF-REF (EMPHASIS-HF 2011)<\/strong> \u2014 37% sn\u00ed\u017een\u00ed kardiovaskul\u00e1rn\u00ed mortality nebo hospitalizace pro srde\u010dn\u00ed selh\u00e1n\u00ed; <strong>prim\u00e1rn\u00ed hyperaldosteronismus<\/strong> a <strong>rezistentn\u00ed hypertenze<\/strong>. Obvykl\u00e1 d\u00e1vka: 25-50 mg jednou denn\u011b. Kontraindikov\u00e1no u hyperkal\u00e9mie &gt;5,5, eGFR &lt;30, Addisonovy choroby a sou\u010dasn\u00e9ho u\u017e\u00edv\u00e1n\u00ed siln\u00fdch inhibitor\u016f CYP3A4. Monitorujte hladinu drasl\u00edku a kreatininu na za\u010d\u00e1tku, po 1 t\u00fddnu, 1 m\u011bs\u00edci a pot\u00e9 ka\u017ed\u00e9 3-4 m\u011bs\u00edce.<\/p>\n<\/div>\n<div class=\"medsbase-trust-strip\" style=\"background:#f4f8fb;border:1px solid #d8e3eb;padding:12px 16px;margin:16px 0;border-radius:4px;font-size:14px;\">\n<strong>Co z\u00edsk\u00e1te s MedsBase:<\/strong> V\u00fdrobce certifikovan\u00fd WHO-GMP \u00b7 Diskr\u00e9tn\u00ed balen\u00ed \u00b7 Celosv\u011btov\u00e1 doprava \u00b7 V\u00edce ne\u017e 1 400 ov\u011b\u0159en\u00fdch <a href=\"https:\/\/medsbase.com\/cs\/reviews\/\">recenz\u00ed z\u00e1kazn\u00edk\u016f<\/a>\n<\/div>\n<p class=\"medsbase-reship-line\" style=\"font-size:14px;color:#444;margin:8px 0 18px;\">\ud83d\udce6 Ka\u017ed\u00e1 objedn\u00e1vka je pokryta na\u0161\u00ed <a href=\"https:\/\/medsbase.com\/cs\/medsbase-re-shipment-assurance-policy\/\"><strong>Z\u00e1rukou op\u011btovn\u00e9ho odesl\u00e1n\u00ed<\/strong><\/a> \u2014 pokud va\u0161e z\u00e1silka nedoraz\u00ed do 20 pracovn\u00edch dn\u016f, p\u0159epos\u00edl\u00e1me ji.<\/p>\n<h3>Pro\u010d objedn\u00e1vat z MedsBase<\/h3>\n<p>Na\u0161e generick\u00e9 l\u00e9ky poch\u00e1zej\u00ed od v\u00fdrobc\u016f certifikovan\u00fdch WHO-GMP a jsou expedov\u00e1ny po cel\u00e9m sv\u011bt\u011b v diskr\u00e9tn\u00edm, nen\u00e1padn\u00e9m balen\u00ed \u2013 na vn\u011bj\u0161\u00ed stran\u011b bal\u00edku nen\u00ed uveden n\u00e1zev l\u00e9ku. Platby kartou jsou sm\u011brov\u00e1ny prost\u0159ednictv\u00edm regulovan\u00e9ho procesoru (popisky na v\u00fdpisu zahrnuj\u00ed regulovan\u00e9ho procesora plateb kartou \u2013 nikdy \u201cMedsBase\u201d nebo n\u00e1zev l\u00e9ku). P\u0159ij\u00edm\u00e1me tak\u00e9 kryptom\u011bny a bankovn\u00ed p\u0159evody SEPA. Ka\u017ed\u00e1 objedn\u00e1vka je zaji\u0161t\u011bna na\u0161\u00ed politikou p\u0159eposl\u00e1n\u00ed.<\/p>\n<h2 class=\"wp-block-heading\">Co je Eptus?<\/h2>\n<p>Eptus jsou tablety eplerenonu 25\/50 mg od Sun Pharma, dod\u00e1van\u00e9 v balen\u00ed po 30-90 tablet\u00e1ch. Eplerenon byl uveden na trh spole\u010dnost\u00ed Pfizer v roce 2002 jako <strong>Inspra<\/strong> \u2014 prvn\u00ed selektivn\u00ed antagonista mineralokortikoidn\u00edho receptoru, vyvinut\u00fd speci\u00e1ln\u011b k zabr\u00e1n\u011bn\u00ed antiandrogenn\u00edch vedlej\u0161\u00edch \u00fa\u010dink\u016f spironolaktonu (gynekomastie, menstrua\u010dn\u00ed nepravidelnosti, sn\u00ed\u017een\u00e9 libido) eliminac\u00ed zk\u0159\u00ed\u017een\u00e9 reaktivity s progesteronov\u00fdmi a androgenn\u00edmi receptory.<\/p>\n<h2 class=\"wp-block-heading\">Jak eplerenon funguje<\/h2>\n<p>Eplerenon selektivn\u011b blokuje <strong>mineralokortikoidn\u00ed receptor (MR)<\/strong> v hlavn\u00edch bu\u0148k\u00e1ch kortik\u00e1ln\u00edho sb\u011brn\u00e9ho kan\u00e1lku. \u00da\u010dinky:<\/p>\n<ul>\n<li><strong>Sn\u00ed\u017een\u00e1 reabsorpce sod\u00edku, sn\u00ed\u017een\u00e9 vylu\u010dov\u00e1n\u00ed drasl\u00edku<\/strong> \u2014 m\u00edrn\u00e1 natriur\u00e9za se zadr\u017eov\u00e1n\u00edm drasl\u00edku (\u0161et\u0159\u00edc\u00ed drasl\u00edk)<\/li>\n<li><strong>Protifibrotick\u00e9 a protiremodela\u010dn\u00ed \u00fa\u010dinky na myokard<\/strong> \u2014 aldosteron podporuje srde\u010dn\u00ed fibr\u00f3zu nez\u00e1visle na sv\u00e9m \u00fa\u010dinku zadr\u017eov\u00e1n\u00ed soli; blokov\u00e1n\u00ed MR sni\u017euje fibr\u00f3zu. Hlavn\u00ed mechanismus sn\u00ed\u017een\u00ed mortality u HF-REF.<\/li>\n<li><strong>\u017d\u00e1dn\u00e1 antiandrogenn\u00ed nebo progestogenn\u00ed aktivita<\/strong> \u2014 kl\u00ed\u010dov\u00fd rozd\u00edl oproti spironolaktonu<\/li>\n<li><strong>Krat\u0161\u00ed polo\u010das ne\u017e spironolakton<\/strong> (4-6 h vs 1,4 h mate\u0159sk\u00e1 l\u00e1tka + 16-24 h metabolity)<\/li>\n<li><strong>Ni\u017e\u0161\u00ed \u00fa\u010dinnost na MR ne\u017e spironolakton<\/strong> \u2014 obvykle vy\u017eaduje 25-50 mg pro ekvivalentn\u00ed \u00fa\u010dinek jako 12,5-25 mg spironolaktonu<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">D\u016fkazy a pou\u017eit\u00ed<\/h2>\n<p><strong>EPHESUS (2003)<\/strong> \u2014 eplerenon 25-50 mg u 6 642 pacient\u016f s postinfarktovou dysfunkc\u00ed LK (EF \u226440%) + srde\u010dn\u00edm selh\u00e1n\u00edm nebo diabetem. 15% sn\u00ed\u017een\u00ed celkov\u00e9 mortality; 17% sn\u00ed\u017een\u00ed kardiovaskul\u00e1rn\u00ed mortality; 21% sn\u00ed\u017een\u00ed n\u00e1hl\u00e9 srde\u010dn\u00ed smrti. Potvrdil eplerenon jako standardn\u00ed terapii pro postinfarktovou dysfunkci LK.<\/p>\n<p><strong>EMPHASIS-HF (2011)<\/strong> \u2014 eplerenon 25-50 mg u 2 737 pacient\u016f s NYHA II HF-REF (EF \u226435%). Studie p\u0159ed\u010dasn\u011b ukon\u010dena pro prok\u00e1zan\u00fd benefit: 37% sn\u00ed\u017een\u00ed kardiovaskul\u00e1rn\u00ed mortality nebo hospitalizace pro srde\u010dn\u00ed selh\u00e1n\u00ed; 24% sn\u00ed\u017een\u00ed celkov\u00e9 mortality. Roz\u0161\u00ed\u0159il indikace antagonist\u016f MR na m\u00edrn\u00e9 symptomatick\u00e9 HF-REF (RALES studoval pouze t\u011b\u017ek\u00e9 srde\u010dn\u00ed selh\u00e1n\u00ed).<\/p>\n<p><strong>Dal\u0161\u00ed pou\u017eit\u00ed:<\/strong><\/p>\n<ul>\n<li><strong>Rezistentn\u00ed hypertenze<\/strong> \u2014 alternativn\u00ed l\u00e9k \u010dtvrt\u00e9 volby p\u0159i intoleranci spironolaktonu kv\u016fli gynekomastii<\/li>\n<li><strong>Prim\u00e1rn\u00ed hyperaldosteronismus (Conn\u016fv syndrom)<\/strong> \u2014 standardn\u00ed medikament\u00f3zn\u00ed l\u00e9\u010dba oboustrann\u00e9 adren\u00e1ln\u00ed hyperplazie p\u0159i \u0161patn\u00e9 toleranci spironolaktonu<\/li>\n<li><strong>HF-REF<\/strong> \u2014 zejm\u00e9na u postinfarktov\u00fdch stav\u016f nebo m\u00edrn\u011b a\u017e st\u0159edn\u011b t\u011b\u017ek\u00e9ho symptomatick\u00e9ho srde\u010dn\u00edho selh\u00e1n\u00ed<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">D\u00e1vkov\u00e1n\u00ed<\/h2>\n<p><strong>Postinfarktov\u00e1 dysfunkce LK nebo HF-REF:<\/strong> za\u010d\u00edt s 25 mg 1\u00d7 denn\u011b; po 4 t\u00fddnech titrovat na 50 mg 1\u00d7 denn\u011b, pokud drasl\u00edk &lt;5,0 a l\u00e9k je dob\u0159e tolerov\u00e1n.<\/p>\n<p><strong>Rezistentn\u00ed hypertenze nebo prim\u00e1rn\u00ed hyperaldosteronismus:<\/strong> 25-50 mg 1\u00d7 denn\u011b; vy\u0161\u0161\u00ed d\u00e1vky (a\u017e 100 mg) v\u00fdjime\u010dn\u011b u Connova syndromu pod odborn\u00fdm dohledem.<\/p>\n<p><strong>Pod\u00e1v\u00e1n\u00ed:<\/strong> s j\u00eddlem nebo nala\u010dno, 1\u00d7 denn\u011b. Rann\u00ed d\u00e1vkov\u00e1n\u00ed obvykle nejpohodln\u011bj\u0161\u00ed; nen\u00ed v\u0161ak vy\u017eadov\u00e1no.<\/p>\n<p><strong>Monitorovac\u00ed pl\u00e1n:<\/strong><\/p>\n<ul>\n<li><strong>Vstupn\u00ed vy\u0161et\u0159en\u00ed:<\/strong> drasl\u00edk (mus\u00ed b\u00fdt &lt;5,0 pro zah\u00e1jen\u00ed l\u00e9\u010dby), kreatinin, eGFR, TK, hodnocen\u00ed p\u0159\u00edznak\u016f.<\/li>\n<li><strong>1 t\u00fdden:<\/strong> opakovat drasl\u00edk a kreatinin.<\/li>\n<li><strong>1 m\u011bs\u00edc a 3 m\u011bs\u00edce:<\/strong> drasl\u00edk, kreatinin, TK.<\/li>\n<li><strong>Pr\u016fb\u011b\u017en\u00e9:<\/strong> ka\u017ed\u00e9 3-4 m\u011bs\u00edce, nebo d\u0159\u00edve p\u0159i zm\u011bn\u011b ren\u00e1ln\u00ed funkce nebo zah\u00e1jen\u00ed interaguj\u00edc\u00edho l\u00e9ku.<\/li>\n<li><strong>Ukon\u010dit nebo sn\u00ed\u017eit d\u00e1vku:<\/strong> drasl\u00edk &gt;5,5, vzestup kreatininu &gt;30%, p\u0159\u00edznaky hyperkal\u00e9mie (slabost, palpitace), t\u011b\u017ek\u00e1 hypotenze.<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Eplerenon vs Spironolakton<\/h2>\n<table style=\"width:100%;border-collapse:collapse;margin:14px 0;\">\n<thead>\n<tr style=\"background:#2c7cb0;color:#fff;\">\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">Vlastnost<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">Eplerenon<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">Spironolakton<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Selektivita k MR<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Vysok\u00e1<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">N\u00edzk\u00e1 (tak\u00e9 AR a PR)<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px;border:1px solid #ddd;\">Gynekomastie<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">&lt;1%<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">5-10% p\u0159i 25-50 mg; a\u017e 50% p\u0159i vysok\u00fdch d\u00e1vk\u00e1ch<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Menstrua\u010dn\u00ed nepravidelnost<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Vz\u00e1cn\u00e9<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">B\u011b\u017en\u00e9<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px;border:1px solid #ddd;\">MR potence<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Ni\u017e\u0161\u00ed (25 mg \u2248 12,5 mg spironolaktonu)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Vy\u0161\u0161\u00ed<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Polo\u010das<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">4-6 h (jednou denn\u011b dosta\u010duj\u00edc\u00ed)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">1,4 h mate\u0159sk\u00e1 l\u00e1tka, 16-24 h metabolity<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px;border:1px solid #ddd;\">Riziko hyperkal\u00e9mie<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Podobn\u00e9<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Podobn\u00e9<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">D\u016fkazn\u00ed z\u00e1kladna (HF-REF)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">EPHESUS (post-MI), EMPHASIS-HF (m\u00edrn\u00e9 HF)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">RALES (t\u011b\u017ek\u00e9 HF)<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px;border:1px solid #ddd;\">D\u016fkazn\u00ed z\u00e1kladna (HTN)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Men\u0161\u00ed studie; 4. linie<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">PATHWAY-2 (nejlep\u0161\u00ed 4. l\u00e1tka)<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Cena<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Vy\u0161\u0161\u00ed<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Ni\u017e\u0161\u00ed (off-patent)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2 class=\"wp-block-heading\">Vedlej\u0161\u00ed \u00fa\u010dinky<\/h2>\n<p><strong>\u010cast\u00e9:<\/strong><\/p>\n<ul>\n<li><strong>Hyperkal\u00e9mie<\/strong> \u2014 d\u00e1vkov\u011b limituj\u00edc\u00ed; z\u00e1va\u017en\u011bj\u0161\u00ed p\u0159i CKD nebo v kombinaci s ACEi\/ARB<\/li>\n<li>Z\u00e1vrat\u011b, ortostatick\u00e1 hypotenze<\/li>\n<li>\u00danava<\/li>\n<li>Mal\u00fd vzestup kreatininu (o\u010dek\u00e1van\u00fd; vy\u0161et\u0159it pokud &gt;30%)<\/li>\n<li>M\u00edrn\u00e9 gastrointestin\u00e1ln\u00ed pot\u00ed\u017ee<\/li>\n<\/ul>\n<p><strong>M\u00e9n\u011b \u010dast\u00e9:<\/strong><\/p>\n<ul>\n<li>T\u011b\u017ek\u00e1 hyperkal\u00e9mie se srde\u010dn\u00ed arytmi\u00ed<\/li>\n<li>Gynekomastie (vz\u00e1cn\u00e9 oproti spironolaktonu)<\/li>\n<li>Angioed\u00e9m (vz\u00e1cn\u00e9)<\/li>\n<li>Hyponatr\u00e9mie<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Kontraindikace<\/h2>\n<ul>\n<li>Hyperkal\u00e9mie &gt;5.0 mmol\/l v\u00fdchoz\u00ed (limit v\u00fdrobce 5.0; n\u011bkter\u00e9 sm\u011brnice 5.5)<\/li>\n<li>T\u011b\u017ek\u00e9 ren\u00e1ln\u00ed posti\u017een\u00ed (eGFR &lt;30)<\/li>\n<li>Addisonova choroba<\/li>\n<li>Sou\u010dasn\u00e9 siln\u00e9 inhibitory CYP3A4 (ketokonazol, itrakonazol, klarithromycin, ritonavir, nelfinavir, nefazodon)<\/li>\n<li>Sou\u010dasn\u00e9 pod\u00e1v\u00e1n\u00ed \u0161et\u0159\u00edc\u00edch drasl\u00edk diuretik nebo dopl\u0148k\u016f drasl\u00edku (pokud nen\u00ed pod odborn\u00fdm dohledem)<\/li>\n<li>Zn\u00e1m\u00e1 p\u0159ecitliv\u011blost<\/li>\n<\/ul>\n<p><strong>T\u011bhotenstv\u00ed:<\/strong> omezen\u00e1 data; na rozd\u00edl od spironolaktonu \u017e\u00e1dn\u00fd antiandrogenn\u00ed mechanismus, ale bezpe\u010dnost nebyla stanovena \u2014 pou\u017e\u00edvejte pouze v p\u0159\u00edpad\u011b, \u017ee p\u0159\u00ednos jasn\u011b p\u0159eva\u017euje riziko. <strong>Kojen\u00ed:<\/strong> omezen\u00e1 data; zva\u017ete alternativu.<\/p>\n<h2 class=\"wp-block-heading\">Interakce s l\u00e9\u010divy<\/h2>\n<ul>\n<li><strong>Siln\u00e9 inhibitory CYP3A4 \u2014 KRITICK\u00c9.<\/strong> Zvy\u0161uj\u00ed hladinu eplerenonu 5-10kr\u00e1t. Kontraindikovan\u00e9 kombinace: ketokonazol, itrakonazol, klarithromycin, nefazodon, nelfinavir, ritonavir. M\u00edrn\u00e9 inhibitory (erythromycin, flukonazol, diltiazem, verapamil) \u2014 zva\u017ete sn\u00ed\u017een\u00ed d\u00e1vky.<\/li>\n<li><strong>ACE inhibitory, ARB, aliskiren<\/strong> \u2014 aditivn\u00ed hyperkalemie; monitorujte hladinu drasl\u00edku t\u00fddn\u011b p\u0159i zah\u00e1jen\u00ed l\u00e9\u010dby.<\/li>\n<li><strong>Diuretika \u0161et\u0159\u00edc\u00ed drasl\u00edk, dopl\u0148ky drasl\u00edku<\/strong> \u2014 aditivn\u00ed hyperkalemie; vyvarujte se.<\/li>\n<li><strong>NSAID<\/strong> \u2014 zvy\u0161uje riziko akutn\u00edho po\u0161kozen\u00ed ledvin p\u0159i kombinaci ACEi\/ARB + eplerenon (\u010dty\u0159n\u00e1sobn\u00fd efekt).<\/li>\n<li><strong>Lithium<\/strong> \u2014 sn\u00ed\u017een\u00e1 clearance; monitorujte hladiny.<\/li>\n<li><strong>T\u0159ezalka te\u010dkovan\u00e1<\/strong> \u2014 indukuje CYP3A4; sni\u017euje hladiny eplerenonu.<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Skladov\u00e1n\u00ed<\/h2>\n<p>Skladujte Eptus p\u0159i teplot\u011b do 25\u00b0C. Uchov\u00e1vejte mimo dosah d\u011bt\u00ed.<\/p>\n<h2 id=\"faqs\">\u010casto kladen\u00e9 dotazy<\/h2>\n<h3 class=\"wp-block-heading\">Pro\u010d zvolit eplerenon m\u00edsto spironolaktonu?<\/h3>\n<p>Dva hlavn\u00ed d\u016fvody: (1) pokud spironolacton zp\u016fsobil gynekomastii, citlivost prsou nebo menstrua\u010dn\u00ed nepravidelnosti \u2014 selektivita eplerenonu v\u016f\u010di mineralokortikoidn\u00edm receptor\u016fm se t\u011bmto \u00fa\u010dink\u016fm vyh\u00fdb\u00e1. (2) Dysfunkce lev\u00e9 komory po infarktu \u2014 studie EPHESUS konkr\u00e9tn\u011b potvrdila \u00fa\u010dinnost eplerenonu u t\u00e9to populace; studie RALES se spironolactonem zkoumala pouze t\u011b\u017ek\u00e9 srde\u010dn\u00ed selh\u00e1n\u00ed. Spironolacton z\u016fst\u00e1v\u00e1 levn\u011bj\u0161\u00ed a \u00fa\u010dinn\u011bj\u0161\u00ed na mg; v\u00fdhody eplerenonu jsou p\u0159edev\u0161\u00edm v lep\u0161\u00ed sn\u00e1\u0161enlivosti a specifick\u00fdch d\u016fkazech pro stav po infarktu.<\/p>\n<h3 class=\"wp-block-heading\">Zv\u00fd\u0161\u00ed Eptus m\u016fj drasl\u00edk?<\/h3>\n<p>Ano \u2014 eplerenon \u0161et\u0159\u00ed drasl\u00edk. Hyperkalemie &gt;5,5 je d\u00e1vkov\u011b limituj\u00edc\u00ed toxicita, nej\u010dast\u011bji u CKD nebo v kombinaci s ACEi\/ARB. Kontrolujte na za\u010d\u00e1tku (mus\u00ed b\u00fdt &lt;5,0), po 1 t\u00fddnu, 1 m\u011bs\u00edci a pot\u00e9 ka\u017ed\u00e9 3-4 m\u011bs\u00edce. P\u0159idejte nebo upravte terapii, pokud drasl\u00edk stoupne nad 5,5.<\/p>\n<h3 class=\"wp-block-heading\">M\u016f\u017eu br\u00e1t ibuprofen s Eptusem?<\/h3>\n<p>Kr\u00e1tkodob\u00e9 u\u017e\u00edv\u00e1n\u00ed je obvykle p\u0159ijateln\u00e9 s monitorov\u00e1n\u00edm drasl\u00edku. Chronick\u00e9 NSAID + ACEi\/ARB + eplerenon v\u00fdrazn\u011b zvy\u0161uj\u00ed riziko AKI (\u010dty\u0159n\u00e1sobn\u00fd efekt). Up\u0159ednostn\u011bte paracetamol.<\/p>\n<h3 class=\"wp-block-heading\">Jak\u00fdm potravin\u00e1m bych se m\u011bl vyhnout?<\/h3>\n<p>N\u00edzkosod\u00edkov\u00e9 n\u00e1hra\u017eky soli (kter\u00e9 \u010dasto obsahuj\u00ed chlorid draseln\u00fd) a potraviny s vysok\u00fdm obsahem drasl\u00edku ve velk\u00e9m mno\u017estv\u00ed (ban\u00e1ny, pomeran\u010de, kokosov\u00e1 voda) \u2014 v\u0161echny zvy\u0161uj\u00ed hladinu drasl\u00edku. Norm\u00e1ln\u00ed porce jsou v po\u0159\u00e1dku; vyhn\u011bte se z\u00e1m\u011brn\u00fdm diet\u00e1m s vysok\u00fdm obsahem drasl\u00edku.<\/p>\n<h3 class=\"wp-block-heading\">Kde m\u016f\u017eu koupit Eptus online?<\/h3>\n<p>Eptus (eplerenon 25\/50 mg, 30-90 tablet) m\u016f\u017eete koupit na MedsBase s diskr\u00e9tn\u00edm balen\u00edm a celosv\u011btovou dopravou.<\/p>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<h2 class=\"wp-block-heading\">Souvisej\u00edc\u00ed kardiologick\u00e1 a hypertenzn\u00ed l\u00e9\u010diva<\/h2>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/cs\/atorvatin\/\">Atorvatin \u2014 Atorvastatin 5 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/ecosprin\/\">Ecosprin \u2014 Aspirin 75\/150 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/lasix-injection\/\">Lasix Injection \u2014 Furosemid 40 mg\/4 mL IV ampule<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/lipvas\/\">Lipvas \u2014 Atorvastatin 10\/20\/40 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/rosuline\/\">Rosuline \u2014 Rosuvastatin 5\/10 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/tenoric\/\">Tenoric \u2014 kombinace atenololu a chlortalidonu<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/high-blood-pressure-medication\/\"><strong>Prohl\u00e9dnout v\u0161echny l\u00e9ky na vysok\u00fd krevn\u00ed tlak<\/strong><\/a><\/li>\n<\/ul>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:16px 20px;margin:24px 0;border-radius:4px;\"><strong>\u2695 L\u00e9ka\u0159sk\u00e9 upozorn\u011bn\u00ed.<\/strong> Tato str\u00e1nka slou\u017e\u00ed pouze pro informa\u010dn\u00ed \u00fa\u010dely a nenahrazuje l\u00e9ka\u0159skou p\u00e9\u010di kvalifikovan\u00e9ho zdravotnick\u00e9ho pracovn\u00edka. Hypertenze, srde\u010dn\u00ed selh\u00e1n\u00ed a arytmie vy\u017eaduj\u00ed diagn\u00f3zu, monitorov\u00e1n\u00ed a individu\u00e1ln\u00ed d\u00e1vkov\u00e1n\u00ed l\u00e9ka\u0159em \u2014 v\u017edy u\u017e\u00edvejte betablok\u00e1tory pod l\u00e9ka\u0159sk\u00fdm dohledem.<\/div>","protected":false},"excerpt":{"rendered":"<p>Eptus jsou tablety eplerenonu 25\/50 mg od Sun Pharma \u2014 selektivn\u00ed antagonista mineralokortikoidn\u00edho receptoru. Vyvinuto spole\u010dnost\u00ed Pfizer jako Inspra (2002) speci\u00e1ln\u011b pro vyhnut\u00ed se antiandrogenn\u00edm vedlej\u0161\u00edm \u00fa\u010dink\u016fm spironolaktonu (gynekomastie 5\u201310 %, menstrua\u010dn\u00ed nepravidelnosti). Studie EPHESUS (2003) potvrdila \u00fa\u010dinnost u postinfarktov\u00e9 dysfunkce LV \u2014 15% sn\u00ed\u017een\u00ed mortality. Studie EMPHASIS-HF (2011) roz\u0161\u00ed\u0159ila indikaci na m\u00edrnou HF-REF \u2014 37% sn\u00ed\u017een\u00ed kardiovaskul\u00e1rn\u00ed mortality\/hospitalizace. Tak\u00e9 pro rezistentn\u00ed hypertenzi a Conn\u016fv syndrom. Pe\u010dliv\u011b monitorujte drasl\u00edk a kreatinin.<\/p>","protected":false},"featured_media":51743,"comment_status":"open","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3141,3223,3260,3356],"product_tag":[3403,3404],"class_list":{"0":"post-51742","1":"product","2":"type-product","3":"status-publish","4":"has-post-thumbnail","6":"product_cat-category-overview","7":"product_cat-chronic-conditions","8":"product_cat-heart-blood-pressure","9":"product_cat-high-blood-pressure-medication","10":"product_tag-eplerenone","11":"product_tag-eptus","13":"first","14":"outofstock","15":"shipping-taxable","16":"purchasable","17":"product-type-variable","18":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product\/51742","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/comments?post=51742"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media\/51743"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media?parent=51742"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_brand?post=51742"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat?post=51742"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_tag?post=51742"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}