{"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\/el\/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;\">&#9889; Quick Answer &mdash; What is Eptus?<\/h3>\n<p style=\"margin:0;\"><strong>Eptus<\/strong> \u03b5\u03af\u03bd\u03b1\u03b9 <strong>25 \/ 50 mg eplerenone tablet<\/strong> from Sun Pharma &mdash; a <strong>selective mineralocorticoid receptor antagonist<\/strong>. Eplerenone differs from spironolactone by its <strong>much higher selectivity for the MR<\/strong> over progesterone and androgen receptors &mdash; avoiding gynaecomastia (5-10% on spironolactone) and menstrual irregularity, at the cost of modestly lower MR potency and higher price. Landmark uses: <strong>post-MI LV dysfunction (EPHESUS 2003)<\/strong> &mdash; 15% all-cause mortality reduction; <strong>mild-to-moderate HF-REF (EMPHASIS-HF 2011)<\/strong> &mdash; 37% reduction in CV death or HF hospitalisation; <strong>primary aldosteronism<\/strong> \u03ba\u03b1\u03b9 <strong>resistant hypertension<\/strong>. Typical dose: 25-50 mg once daily. Contraindicated in hyperkalaemia &gt;5.5, eGFR &lt;30, Addison disease, concurrent strong CYP3A4 inhibitors. Monitor potassium and creatinine at baseline, 1 week, 1 month, then every 3-4 months.<\/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>\u0391\u03c5\u03c4\u03cc \u03c0\u03bf\u03c5 \u03bb\u03b1\u03bc\u03b2\u03ac\u03bd\u03b5\u03c4\u03b5 \u03bc\u03b5 \u03c4\u03b7\u03bd MedsBase:<\/strong> \u03a0\u03b9\u03c3\u03c4\u03bf\u03c0\u03bf\u03b9\u03b7\u03bc\u03ad\u03bd\u03bf\u03c2 \u03ba\u03b1\u03c4\u03b1\u03c3\u03ba\u03b5\u03c5\u03b1\u03c3\u03c4\u03ae\u03c2 WHO-GMP \u00b7 \u0394\u03b9\u03b1\u03ba\u03c1\u03b9\u03c4\u03b9\u03ba\u03ae \u03c3\u03c5\u03c3\u03ba\u03b5\u03c5\u03b1\u03c3\u03af\u03b1 \u00b7 \u03a0\u03b1\u03b3\u03ba\u03cc\u03c3\u03bc\u03b9\u03b1 \u03b1\u03c0\u03bf\u03c3\u03c4\u03bf\u03bb\u03ae \u00b7 1,400+ \u03b5\u03c0\u03b1\u03bb\u03b7\u03b8\u03b5\u03c5\u03bc\u03ad\u03bd\u03b5\u03c2 <a href=\"https:\/\/medsbase.com\/el\/reviews\/\">\u03ba\u03c1\u03b9\u03c4\u03b9\u03ba\u03ad\u03c2 \u03c0\u03b5\u03bb\u03b1\u03c4\u03ce\u03bd<\/a>\n<\/div>\n<p class=\"medsbase-reship-line\" style=\"font-size:14px;color:#444;margin:8px 0 18px;\">\ud83d\udce6 \u039a\u03ac\u03b8\u03b5 \u03c0\u03b1\u03c1\u03b1\u03b3\u03b3\u03b5\u03bb\u03af\u03b1 \u03ba\u03b1\u03bb\u03cd\u03c0\u03c4\u03b5\u03c4\u03b1\u03b9 \u03b1\u03c0\u03cc \u03c4\u03b7\u03bd <a href=\"https:\/\/medsbase.com\/el\/medsbase-re-shipment-assurance-policy\/\"><strong>\u03a0\u03bf\u03bb\u03b9\u03c4\u03b9\u03ba\u03ae \u0395\u03b3\u03b3\u03cd\u03b7\u03c3\u03b7\u03c2 \u0395\u03c0\u03b1\u03bd\u03b1\u03c0\u03bf\u03c3\u03c4\u03bf\u03bb\u03ae\u03c2<\/strong><\/a> \u2014 \u03b5\u03ac\u03bd \u03c4\u03bf \u03b4\u03ad\u03bc\u03b1 \u03c3\u03b1\u03c2 \u03b4\u03b5\u03bd \u03c6\u03c4\u03ac\u03c3\u03b5\u03b9 \u03b5\u03bd\u03c4\u03cc\u03c2 20 \u03b5\u03c1\u03b3\u03ac\u03c3\u03b9\u03bc\u03c9\u03bd \u03b7\u03bc\u03b5\u03c1\u03ce\u03bd, \u03c4\u03bf \u03b5\u03c0\u03b1\u03bd\u03b1\u03c0\u03bf\u03c3\u03c4\u03ad\u03bb\u03bb\u03bf\u03c5\u03bc\u03b5.<\/p>\n<h3>\u0393\u03b9\u03b1\u03c4\u03af \u03bd\u03b1 \u03c0\u03b1\u03c1\u03b1\u03b3\u03b3\u03b5\u03af\u03bb\u03b5\u03c4\u03b5 \u03b1\u03c0\u03cc \u03c4\u03b7 MedsBase<\/h3>\n<p>\u03a4\u03b1 \u03b3\u03b5\u03bd\u03cc\u03c3\u03b7\u03bc\u03b1 \u03c6\u03ac\u03c1\u03bc\u03b1\u03ba\u03ac \u03bc\u03b1\u03c2 \u03c0\u03c1\u03bf\u03ad\u03c1\u03c7\u03bf\u03bd\u03c4\u03b1\u03b9 \u03b1\u03c0\u03cc \u03ba\u03b1\u03c4\u03b1\u03c3\u03ba\u03b5\u03c5\u03b1\u03c3\u03c4\u03ad\u03c2 \u03c0\u03bf\u03c5 \u03c0\u03b9\u03c3\u03c4\u03bf\u03c0\u03bf\u03b9\u03bf\u03cd\u03bd\u03c4\u03b1\u03b9 \u03b1\u03c0\u03cc \u03c4\u03b7\u03bd WHO-GMP \u03ba\u03b1\u03b9 \u03b1\u03c0\u03bf\u03c3\u03c4\u03ad\u03bb\u03bb\u03bf\u03bd\u03c4\u03b1\u03b9 \u03c0\u03b1\u03b3\u03ba\u03bf\u03c3\u03bc\u03af\u03c9\u03c2 \u03c3\u03b5 \u03b4\u03b9\u03b1\u03ba\u03c1\u03b9\u03c4\u03b9\u03ba\u03ae, \u03b1\u03c0\u03bb\u03ae \u03c3\u03c5\u03c3\u03ba\u03b5\u03c5\u03b1\u03c3\u03af\u03b1 \u2014 \u03c7\u03c9\u03c1\u03af\u03c2 \u03cc\u03bd\u03bf\u03bc\u03b1 \u03c6\u03b1\u03c1\u03bc\u03ac\u03ba\u03bf\u03c5 \u03c3\u03c4\u03bf \u03b5\u03be\u03c9\u03c4\u03b5\u03c1\u03b9\u03ba\u03cc \u03c4\u03bf\u03c5 \u03b4\u03ad\u03bc\u03b1\u03c4\u03bf\u03c2. \u039f\u03b9 \u03c0\u03bb\u03b7\u03c1\u03c9\u03bc\u03ad\u03c2 \u03bc\u03b5 \u03ba\u03ac\u03c1\u03c4\u03b1 \u03b4\u03c1\u03bf\u03bc\u03bf\u03bb\u03bf\u03b3\u03bf\u03cd\u03bd\u03c4\u03b1\u03b9 \u03bc\u03ad\u03c3\u03c9 \u03c1\u03c5\u03b8\u03bc\u03b9\u03c3\u03bc\u03ad\u03bd\u03bf\u03c5 \u03b5\u03c0\u03b5\u03be\u03b5\u03c1\u03b3\u03b1\u03c3\u03c4\u03ae (\u03bf\u03b9 \u03c0\u03b5\u03c1\u03b9\u03b3\u03c1\u03b1\u03c6\u03ad\u03c2 \u03b5\u03ba\u03ba\u03b1\u03b8\u03ac\u03c1\u03b9\u03c3\u03b7\u03c2 \u03c0\u03b5\u03c1\u03b9\u03bb\u03b1\u03bc\u03b2\u03ac\u03bd\u03bf\u03c5\u03bd \u03c1\u03c5\u03b8\u03bc\u03b9\u03c3\u03bc\u03ad\u03bd\u03bf \u03b5\u03c0\u03b5\u03be\u03b5\u03c1\u03b3\u03b1\u03c3\u03c4\u03ae \u03c0\u03bb\u03b7\u03c1\u03c9\u03bc\u03ce\u03bd \u03bc\u03b5 \u03ba\u03ac\u03c1\u03c4\u03b1 \u2014 \u03c0\u03bf\u03c4\u03ad \u201cMedsBase\u201d \u03ae \u03bf\u03c0\u03bf\u03b9\u03bf\u03b4\u03ae\u03c0\u03bf\u03c4\u03b5 \u03cc\u03bd\u03bf\u03bc\u03b1 \u03c6\u03b1\u03c1\u03bc\u03ac\u03ba\u03bf\u03c5). \u0393\u03af\u03bd\u03bf\u03bd\u03c4\u03b1\u03b9 \u03b4\u03b5\u03ba\u03c4\u03ad\u03c2 \u03ba\u03b1\u03b9 \u03c0\u03bb\u03b7\u03c1\u03c9\u03bc\u03ad\u03c2 \u03bc\u03b5 \u03ba\u03c1\u03c5\u03c0\u03c4\u03bf\u03bd\u03bf\u03bc\u03af\u03c3\u03bc\u03b1\u03c4\u03b1 \u03ba\u03b1\u03b9 \u03c4\u03c1\u03b1\u03c0\u03b5\u03b6\u03b9\u03ba\u03ae \u03bc\u03b5\u03c4\u03b1\u03c6\u03bf\u03c1\u03ac SEPA. \u039a\u03ac\u03b8\u03b5 \u03c0\u03b1\u03c1\u03b1\u03b3\u03b3\u03b5\u03bb\u03af\u03b1 \u03ba\u03b1\u03bb\u03cd\u03c0\u03c4\u03b5\u03c4\u03b1\u03b9 \u03b1\u03c0\u03cc \u03c4\u03b7\u03bd \u03a0\u03bf\u03bb\u03b9\u03c4\u03b9\u03ba\u03ae \u0395\u03c0\u03b1\u03bd\u03b1\u03c0\u03bf\u03c3\u03c4\u03bf\u03bb\u03ae\u03c2 \u0395\u03be\u03b1\u03c3\u03c6\u03b1\u03bb\u03af\u03c3\u03b5\u03ce\u03c2 \u03bc\u03b1\u03c2.<\/p>\n<h2 class=\"wp-block-heading\">What Is Eptus?<\/h2>\n<p>Eptus is 25 \/ 50 mg eplerenone tablets from Sun Pharma, supplied in 30-90 tablets. Eplerenone was introduced by Pfizer in 2002 as <strong>Inspra<\/strong> &mdash; the first selective mineralocorticoid receptor antagonist, developed specifically to avoid the anti-androgen side effects of spironolactone (gynaecomastia, menstrual irregularity, decreased libido) by eliminating cross-reactivity with progesterone and androgen receptors.<\/p>\n<h2 class=\"wp-block-heading\">How Eplerenone Works<\/h2>\n<p>Eplerenone selectively antagonises the <strong>mineralocorticoid receptor (MR)<\/strong> in the principal cells of the cortical collecting duct. Effects:<\/p>\n<ul>\n<li><strong>Reduced sodium reabsorption, reduced potassium excretion<\/strong> &mdash; mild natriuresis with potassium retention (potassium-sparing)<\/li>\n<li><strong>Anti-fibrotic and anti-remodelling effects on myocardium<\/strong> &mdash; aldosterone drives cardiac fibrosis independent of its salt-retaining effect; blocking MR reduces fibrosis. Main mechanism of HF-REF mortality benefit.<\/li>\n<li><strong>No anti-androgen or progestogenic activity<\/strong> &mdash; the key differentiator from spironolactone<\/li>\n<li><strong>Shorter half-life than spironolactone<\/strong> (4-6 h vs 1.4 h parent + 16-24 h metabolites)<\/li>\n<li><strong>Lower potency at MR than spironolactone<\/strong> &mdash; typically requires 25-50 mg for equivalent effect to spironolactone 12.5-25 mg<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Evidence and Uses<\/h2>\n<p><strong>EPHESUS (2003)<\/strong> &mdash; eplerenone 25-50 mg in 6,642 patients with post-MI LV dysfunction (EF &le;40%) + HF or diabetes. 15% reduction in all-cause mortality; 17% reduction in cardiovascular mortality; 21% reduction in sudden cardiac death. Established eplerenone as standard therapy for post-MI LV dysfunction.<\/p>\n<p><strong>EMPHASIS-HF (2011)<\/strong> &mdash; eplerenone 25-50 mg in 2,737 patients with NYHA II HF-REF (EF &le;35%). Stopped early for benefit: 37% reduction in CV death or HF hospitalisation; 24% reduction in all-cause mortality. Extended MR antagonist indications to mild symptomatic HF-REF (RALES had studied only severe HF).<\/p>\n<p><strong>Other uses:<\/strong><\/p>\n<ul>\n<li><strong>\u0391\u03bd\u03b8\u03b5\u03ba\u03c4\u03b9\u03ba\u03ae \u03c5\u03c0\u03ad\u03c1\u03c4\u03b1\u03c3\u03b7<\/strong> &mdash; an alternative fourth-line agent when spironolactone is intolerable due to gynaecomastia<\/li>\n<li><strong>Primary aldosteronism (Conn syndrome)<\/strong> &mdash; standard medical therapy for bilateral adrenal hyperplasia when spironolactone is poorly tolerated<\/li>\n<li><strong>HF-REF<\/strong> &mdash; particularly in post-MI or mild-moderate symptomatic HF<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">\u0394\u03bf\u03c3\u03bf\u03bb\u03bf\u03b3\u03af\u03b1<\/h2>\n<p><strong>Post-MI LV dysfunction or HF-REF:<\/strong> start 25 mg once daily; titrate to 50 mg once daily at 4 weeks if potassium &lt;5.0 and tolerated.<\/p>\n<p><strong>Resistant hypertension or primary aldosteronism:<\/strong> 25-50 mg once daily; higher doses (up to 100 mg) occasionally in Conn syndrome under specialist care.<\/p>\n<p><strong>\u03a7\u03bf\u03c1\u03ae\u03b3\u03b7\u03c3\u03b7:<\/strong> with or without food, once daily. Morning dosing usually easiest; not required.<\/p>\n<p><strong>\u03a0\u03c1\u03cc\u03b3\u03c1\u03b1\u03bc\u03bc\u03b1 \u03c0\u03b1\u03c1\u03b1\u03ba\u03bf\u03bb\u03bf\u03cd\u03b8\u03b7\u03c3\u03b7\u03c2:<\/strong><\/p>\n<ul>\n<li><strong>\u0392\u03b1\u03c3\u03b9\u03ba\u03ae \u03b1\u03be\u03b9\u03bf\u03bb\u03cc\u03b3\u03b7\u03c3\u03b7:<\/strong> potassium (must be &lt;5.0 to start), creatinine, eGFR, BP, symptom assessment.<\/li>\n<li><strong>1 week:<\/strong> repeat potassium and creatinine.<\/li>\n<li><strong>1 month and 3 months:<\/strong> potassium, creatinine, BP.<\/li>\n<li><strong>\u03a3\u03c5\u03bd\u03b5\u03c7\u03ae\u03c2 \u03c0\u03b1\u03c1\u03b1\u03ba\u03bf\u03bb\u03bf\u03cd\u03b8\u03b7\u03c3\u03b7:<\/strong> every 3-4 months, or sooner if renal function changes or interacting drug started.<\/li>\n<li><strong>Stop or reduce:<\/strong> potassium &gt;5.5, creatinine rise &gt;30%, symptoms of hyperkalaemia (weakness, palpitations), severe hypotension.<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Eplerenone vs Spironolactone<\/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;\">\u03a7\u03b1\u03c1\u03b1\u03ba\u03c4\u03b7\u03c1\u03b9\u03c3\u03c4\u03b9\u03ba\u03cc<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">Eplerenone<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">\u03a3\u03c0\u03b9\u03c1\u03bf\u03bd\u03bf\u03bb\u03b1\u03ba\u03c4\u03cc\u03bd\u03b7<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">MR selectivity<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">High<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Low (also AR and PR)<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px;border:1px solid #ddd;\">Gynaecomastia<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">&lt;1%<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">5-10% at 25-50 mg; up to 50% at high doses<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Menstrual irregularity<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">\u03a3\u03c0\u03ac\u03bd\u03b9\u03b5\u03c2<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">\u03a3\u03c5\u03c7\u03bd\u03ac<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px;border:1px solid #ddd;\">MR potency<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Lower (25 mg &asymp; 12.5 mg spironolactone)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">\u03a5\u03c8\u03b7\u03bb\u03cc\u03c4\u03b5\u03c1\u03bf<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Half-life<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">4-6 h (once daily adequate)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">1.4 h parent, 16-24 h metabolites<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px;border:1px solid #ddd;\">Hyperkalaemia risk<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Similar<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Similar<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Evidence base (HF-REF)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">EPHESUS (post-MI), EMPHASIS-HF (mild HF)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">RALES (severe HF)<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px;border:1px solid #ddd;\">Evidence base (HTN)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Smaller trials; 4th-line<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">PATHWAY-2 (best 4th agent)<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">\u039a\u03cc\u03c3\u03c4\u03bf\u03c2<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">\u03a5\u03c8\u03b7\u03bb\u03cc\u03c4\u03b5\u03c1\u03bf<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Lower (off-patent)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2 class=\"wp-block-heading\">\u03a0\u03b1\u03c1\u03b5\u03bd\u03ad\u03c1\u03b3\u03b5\u03b9\u03b5\u03c2<\/h2>\n<p><strong>\u03a3\u03c5\u03c7\u03bd\u03ad\u03c2:<\/strong><\/p>\n<ul>\n<li><strong>Hyperkalaemia<\/strong> &mdash; dose-limiting; more severe in CKD or with ACEi\/ARB combinations<\/li>\n<li>\u0396\u03ac\u03bb\u03b7, \u03bf\u03c1\u03b8\u03bf\u03c3\u03c4\u03b1\u03c4\u03b9\u03ba\u03ae \u03c5\u03c0\u03cc\u03c4\u03b1\u03c3\u03b7<\/li>\n<li>\u039a\u03bf\u03cd\u03c1\u03b1\u03c3\u03b7<\/li>\n<li>Small creatinine rise (expected; investigate if &gt;30%)<\/li>\n<li>Mild gastrointestinal upset<\/li>\n<\/ul>\n<p><strong>\u0391\u03c3\u03c5\u03bd\u03ae\u03b8\u03b9\u03c3\u03c4\u03b5\u03c2:<\/strong><\/p>\n<ul>\n<li>Severe hyperkalaemia with cardiac arrhythmia<\/li>\n<li>Gynaecomastia (rare vs spironolactone)<\/li>\n<li>Angioedema (rare)<\/li>\n<li>\u03a5\u03c0\u03bf\u03bd\u03b1\u03c4\u03c1\u03b9\u03b1\u03b9\u03bc\u03af\u03b1<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">\u0391\u03bd\u03c4\u03b5\u03bd\u03b4\u03b5\u03af\u03be\u03b5\u03b9\u03c2<\/h2>\n<ul>\n<li>Hyperkalaemia &gt;5.0 mmol\/L at baseline (manufacturer cut-off 5.0; some guidelines 5.5)<\/li>\n<li>Severe renal impairment (eGFR &lt;30)<\/li>\n<li>Addison disease<\/li>\n<li>Concurrent strong CYP3A4 inhibitors (ketoconazole, itraconazole, clarithromycin, ritonavir, nelfinavir, nefazodone)<\/li>\n<li>Concurrent potassium-sparing diuretics or potassium supplements (unless under specialist monitoring)<\/li>\n<li>\u0393\u03bd\u03c9\u03c3\u03c4\u03ae \u03c5\u03c0\u03b5\u03c1\u03b5\u03c5\u03b1\u03b9\u03c3\u03b8\u03b7\u03c3\u03af\u03b1<\/li>\n<\/ul>\n<p><strong>\u0395\u03b3\u03ba\u03c5\u03bc\u03bf\u03c3\u03cd\u03bd\u03b7:<\/strong> limited data; unlike spironolactone, no anti-androgen mechanism, but safety not established &mdash; use only if benefit clearly outweighs risk. <strong>\u0398\u03b7\u03bb\u03b1\u03c3\u03bc\u03cc\u03c2:<\/strong> limited data; consider alternative.<\/p>\n<h2 class=\"wp-block-heading\">\u0391\u03bb\u03bb\u03b7\u03bb\u03b5\u03c0\u03b9\u03b4\u03c1\u03ac\u03c3\u03b5\u03b9\u03c2 \u03a6\u03b1\u03c1\u03bc\u03ac\u03ba\u03c9\u03bd<\/h2>\n<ul>\n<li><strong>Strong CYP3A4 inhibitors &mdash; CRITICAL.<\/strong> Raise eplerenone levels 5-10 fold. Contraindicated combinations: ketoconazole, itraconazole, clarithromycin, nefazodone, nelfinavir, ritonavir. Moderate inhibitors (erythromycin, fluconazole, diltiazem, verapamil) &mdash; consider dose reduction.<\/li>\n<li><strong>ACE inhibitors, ARBs, aliskiren<\/strong> &mdash; additive hyperkalaemia; monitor potassium weekly on initiation.<\/li>\n<li><strong>Potassium-sparing diuretics, potassium supplements<\/strong> &mdash; additive hyperkalaemia; avoid.<\/li>\n<li><strong>\u039c\u03b7 \u03c3\u03c4\u03b5\u03c1\u03bf\u03b5\u03b9\u03b4\u03ae \u03b1\u03bd\u03c4\u03b9\u03c6\u03bb\u03b5\u03b3\u03bc\u03bf\u03bd\u03ce\u03b4\u03b7 \u03c6\u03ac\u03c1\u03bc\u03b1\u03ba\u03b1 (NSAIDs)<\/strong> &mdash; raise AKI risk with ACEi\/ARB + eplerenone (quadruple-whammy).<\/li>\n<li><strong>\u039b\u03b9\u03b8\u03b9\u03bf<\/strong> &mdash; reduced clearance; monitor levels.<\/li>\n<li><strong>St John&rsquo;s Wort<\/strong> &mdash; induces CYP3A4; reduces eplerenone levels.<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">\u0391\u03c0\u03bf\u03b8\u03ae\u03ba\u03b5\u03c5\u03c3\u03b7<\/h2>\n<p>Store Eptus below 25&deg;C. Keep out of reach of children.<\/p>\n<h2 id=\"faqs\">\u03a3\u03c5\u03c7\u03bd\u03ad\u03c2 \u0395\u03c1\u03c9\u03c4\u03ae\u03c3\u03b5\u03b9\u03c2<\/h2>\n<h3 class=\"wp-block-heading\">Why choose eplerenone over spironolactone?<\/h3>\n<p>Two main reasons: (1) if spironolactone has caused gynaecomastia, breast tenderness, or menstrual irregularity &mdash; eplerenone&rsquo;s MR selectivity avoids these. (2) Post-MI LV dysfunction &mdash; EPHESUS specifically validated eplerenone in this population; spironolactone&rsquo;s RALES studied severe HF only. Spironolactone remains cheaper and more potent per mg; eplerenone&rsquo;s advantages are primarily tolerability and specific post-MI evidence.<\/p>\n<h3 class=\"wp-block-heading\">Will Eptus raise my potassium?<\/h3>\n<p>Yes &mdash; eplerenone is potassium-sparing. Hyperkalaemia &gt;5.5 is the dose-limiting toxicity, most commonly in CKD or combined with ACEi\/ARB. Check at baseline (must be &lt;5.0), 1 week, 1 month, and then every 3-4 months. Add or adjust therapy if potassium rises above 5.5.<\/p>\n<h3 class=\"wp-block-heading\">Can I take ibuprofen with Eptus?<\/h3>\n<p>Short courses are usually acceptable with potassium monitoring. Chronic NSAIDs + ACEi\/ARB + eplerenone substantially raise AKI risk (quadruple whammy). Prefer paracetamol.<\/p>\n<h3 class=\"wp-block-heading\">What foods should I avoid?<\/h3>\n<p>Low-sodium salt substitutes (which often use potassium chloride) and high-potassium foods in large quantities (bananas, oranges, coconut water) &mdash; all push potassium higher. Normal portions are fine; avoid deliberate potassium-loading diets.<\/p>\n<h3 class=\"wp-block-heading\">Where can I buy Eptus online?<\/h3>\n<p>You can buy Eptus (eplerenone 25 \/ 50 mg, 30-90 tablets) from MedsBase with discreet packaging and worldwide shipping.<\/p>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<h2 class=\"wp-block-heading\">\u03a3\u03c7\u03b5\u03c4\u03b9\u03ba\u03ac \u039a\u03b1\u03c1\u03b4\u03b9\u03b1\u03ba\u03ac &amp; \u03a5\u03c0\u03b5\u03c1\u03c4\u03b1\u03c3\u03b9\u03ba\u03ac \u03a6\u03ac\u03c1\u03bc\u03b1\u03ba\u03b1<\/h2>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/el\/atorvatin\/\">Atorvatin \u2014 \u0391\u03c4\u03bf\u03c1\u03b2\u03b1\u03c3\u03c4\u03b1\u03c4\u03af\u03bd\u03b7 5 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/el\/ecosprin\/\">Ecosprin \u2014 \u0391\u03c3\u03c0\u03b9\u03c1\u03af\u03bd\u03b7 75\/150 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/el\/lasix-injection\/\">Lasix Injection \u2014 \u03a6\u03bf\u03c5\u03c1\u03bf\u03c3\u03b5\u03bc\u03af\u03b4\u03b7 40 mg\/4 mL IV \u03b1\u03bc\u03c0\u03bf\u03cd\u03bb\u03b5\u03c2<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/el\/lipvas\/\">Lipvas \u2014 \u0391\u03c4\u03bf\u03c1\u03b2\u03b1\u03c3\u03c4\u03b1\u03c4\u03af\u03bd\u03b7 10\/20\/40 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/el\/rosuline\/\">Rosuline &mdash; Rosuvastatin 5\/10 mg<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/el\/tenoric\/\">Tenoric &mdash; Atenolol + Chlorthalidone combo<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/el\/high-blood-pressure-medication\/\"><strong>\u03a0\u03b5\u03c1\u03b9\u03ae\u03b3\u03b7\u03c3\u03b7 \u03c3\u03b5 \u03cc\u03bb\u03b1 \u03c4\u03b1 \u03a6\u03ac\u03c1\u03bc\u03b1\u03ba\u03b1 \u03b3\u03b9\u03b1 \u03a5\u03c8\u03b7\u03bb\u03ae \u03a0\u03af\u03b5\u03c3\u03b7 \u0391\u03af\u03bc\u03b1\u03c4\u03bf\u03c2<\/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 \u0399\u03b1\u03c4\u03c1\u03b9\u03ba\u03ae \u0391\u03c0\u03bf\u03c0\u03bf\u03af\u03b7\u03c3\u03b7 \u0395\u03c5\u03b8\u03cd\u03bd\u03b7\u03c2.<\/strong> \u0391\u03c5\u03c4\u03ae \u03b7 \u03c3\u03b5\u03bb\u03af\u03b4\u03b1 \u03b5\u03af\u03bd\u03b1\u03b9 \u03bc\u03cc\u03bd\u03bf \u03b3\u03b9\u03b1 \u03b5\u03bd\u03b7\u03bc\u03b5\u03c1\u03c9\u03c4\u03b9\u03ba\u03bf\u03cd\u03c2 \u03c3\u03ba\u03bf\u03c0\u03bf\u03cd\u03c2 \u03ba\u03b1\u03b9 \u03b4\u03b5\u03bd \u03b1\u03bd\u03c4\u03b9\u03ba\u03b1\u03b8\u03b9\u03c3\u03c4\u03ac \u03c4\u03b7\u03bd \u03b9\u03b1\u03c4\u03c1\u03b9\u03ba\u03ae \u03c3\u03c5\u03bc\u03b2\u03bf\u03c5\u03bb\u03ae \u03b1\u03c0\u03cc \u03ad\u03bd\u03b1\u03bd \u03ba\u03b1\u03c4\u03b1\u03be\u03b9\u03c9\u03bc\u03ad\u03bd\u03bf \u03b5\u03c0\u03b1\u03b3\u03b3\u03b5\u03bb\u03bc\u03b1\u03c4\u03af\u03b1 \u03c5\u03b3\u03b5\u03af\u03b1\u03c2. \u0397 \u03c5\u03c0\u03ad\u03c1\u03c4\u03b1\u03c3\u03b7, \u03b7 \u03ba\u03b1\u03c1\u03b4\u03b9\u03b1\u03ba\u03ae \u03b1\u03bd\u03b5\u03c0\u03ac\u03c1\u03ba\u03b5\u03b9\u03b1 \u03ba\u03b1\u03b9 \u03bf\u03b9 \u03b1\u03c1\u03c1\u03c5\u03b8\u03bc\u03af\u03b5\u03c2 \u03b1\u03c0\u03b1\u03b9\u03c4\u03bf\u03cd\u03bd \u03b4\u03b9\u03ac\u03b3\u03bd\u03c9\u03c3\u03b7, \u03c0\u03b1\u03c1\u03b1\u03ba\u03bf\u03bb\u03bf\u03cd\u03b8\u03b7\u03c3\u03b7 \u03ba\u03b1\u03b9 \u03b1\u03c4\u03bf\u03bc\u03b9\u03ba\u03ae \u03c0\u03c1\u03bf\u03c3\u03b1\u03c1\u03bc\u03bf\u03b3\u03ae \u03b4\u03cc\u03c3\u03b7\u03c2 \u03b1\u03c0\u03cc \u03b3\u03b9\u03b1\u03c4\u03c1\u03cc \u2014 \u03c0\u03ac\u03bd\u03c4\u03b1 \u03c7\u03c1\u03b7\u03c3\u03b9\u03bc\u03bf\u03c0\u03bf\u03b9\u03b5\u03af\u03c4\u03b5 \u03b2-\u03b1\u03bd\u03b1\u03c3\u03c4\u03bf\u03bb\u03b5\u03af\u03c2 \u03c5\u03c0\u03cc \u03b9\u03b1\u03c4\u03c1\u03b9\u03ba\u03ae \u03b5\u03c0\u03af\u03b2\u03bb\u03b5\u03c8\u03b7.<\/div>","protected":false},"excerpt":{"rendered":"<p>Eptus is Sun Pharma&#8217;s eplerenone 25\/50 mg tablets \u2014 selective mineralocorticoid receptor antagonist. Developed by Pfizer as Inspra (2002) specifically to avoid spironolactone&#8217;s anti-androgen side effects (gynaecomastia 5-10%, menstrual irregularity). EPHESUS (2003) validated in post-MI LV dysfunction \u2014 15% mortality reduction. EMPHASIS-HF (2011) extended to mild HF-REF \u2014 37% reduction in CV death\/hospitalisation. Also for resistant HTN, Conn syndrome. Monitor potassium and creatinine closely.<\/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\/el\/wp-json\/wp\/v2\/product\/51742","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/el\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/el\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/el\/wp-json\/wp\/v2\/comments?post=51742"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/el\/wp-json\/wp\/v2\/media\/51743"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/el\/wp-json\/wp\/v2\/media?parent=51742"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/el\/wp-json\/wp\/v2\/product_brand?post=51742"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/el\/wp-json\/wp\/v2\/product_cat?post=51742"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/el\/wp-json\/wp\/v2\/product_tag?post=51742"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}