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CARDIOVASCULAR SYSTEM › DIURETICS › ALDOSTERONE ANTAGONISTS AND OTHER POTASSIUM-SPARING AGENTS › Aldosterone antagonists
eplerenone and dapagliflozin
C03DA54
Forms & Strengths
- Eplerenone 25mg and dapagliflozin 10mg
- Eplerenone 50mg and dapagliflozin 10mg
- Tablets
Adult Dosing
- Initiate with eplerenone 25mg and dapagliflozin 5mg, titrate as needed and tolerated
- Maximum dose eplerenone 50mg and dapagliflozin 10mg daily
- Dose adjustment for renal impairment and hepatic impairment
Pediatric Dosing
- Not established for patients under 18 years old
Indications
- Treatment of heart failure with reduced ejection fraction (HFrEF)
- Treatment of type 2 diabetes mellitus as an adjunct to diet and exercise
Mechanism of Action
- Eplerenone: selective aldosterone receptor antagonist
- Dapagliflozin: sodium-glucose cotransporter 2 (SGLT2) inhibitor
- Combination reduces fluid overload, improves glycemic control and reduces hospitalization due to heart failure
Contraindications
- Hypersensitivity to eplerenone or dapagliflozin
- Severe renal impairment (eGFR < 30 mL/min/1.73 m^2)
- Severe hepatic impairment (Child-Pugh C)
- Diabetic ketoacidosis
Adverse Reactions
- Hyperkalemia
- Hypotension
- Volume depletion
- Urinary tract infections
- Genital mycotic infections
- Hypoglycemia
Drug Interactions
- Potassium-sparing diuretics: increased risk of hyperkalemia
- Lithium: increased risk of lithium toxicity
- Digoxin: increased risk of digoxin toxicity
- NSAIDs: decreased renal function
- ACE inhibitors and ARBs: increased risk of hyperkalemia and hypotension
Curated Content: Needs Vetting Before Put to Clinical Use