Aldosterone antagonist: Difference between revisions
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In [[pharmacology]], '''aldosterone antagonists''' are "compounds which inhibit or antagonize the biosynthesis or actions of [[aldosterone]]."<ref>{{MeSH}}</ref> Their actions affect the larger [[renin-angiotensin system]]. | In [[pharmacology]], '''aldosterone antagonists''' are "compounds which inhibit or antagonize the biosynthesis or actions of [[aldosterone]]."<ref>{{MeSH}}</ref> Their actions affect the larger [[renin-angiotensin system]]. | ||
==Availability== | |||
{| class="wikitable" align="right" | |||
|+ Costs of (prices from Drugstore.com 2/2011) | |||
! Drug!! Size!!Cost per 90 pills | |||
|- | |||
| Eplerenone (Inspra brand)|| 50 mg || $405.09 | |||
|- | |||
| Eplerenone (generic)|| 50 mg || $275.99 | |||
|- | |||
| Spironolactone (Aldactone brand)|| 25 mg ||$96.97 | |||
|- | |||
| Spironolactone (generic)|| 25 mg ||$29.97 | |||
|} | |||
* Canrenone | * Canrenone | ||
* Drospirenone | * Drospirenone | ||
Line 11: | Line 24: | ||
* [[Ascites]] | * [[Ascites]] | ||
* [[Chronic kidney disease]]<ref name="pmid19588415">{{cite journal| author=Navaneethan SD, Nigwekar SU, Sehgal AR, Strippoli GF| title=Aldosterone antagonists for preventing the progression of chronic kidney disease. | journal=Cochrane Database Syst Rev | year= 2009 | volume= | issue= 3 | pages= CD007004 | pmid=19588415 | * [[Chronic kidney disease]]<ref name="pmid19588415">{{cite journal| author=Navaneethan SD, Nigwekar SU, Sehgal AR, Strippoli GF| title=Aldosterone antagonists for preventing the progression of chronic kidney disease. | journal=Cochrane Database Syst Rev | year= 2009 | volume= | issue= 3 | pages= CD007004 | pmid=19588415 | ||
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&email=badgett@uthscdsa.edu&retmode=ref&cmd=prlinks&id=19588415 | doi=10.1002/14651858.CD007004.pub2 }} | | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&email=badgett@uthscdsa.edu&retmode=ref&cmd=prlinks&id=19588415 | doi=10.1002/14651858.CD007004.pub2 }}</ref> | ||
* [[Hirsutism]]<ref name="pmid19370553">{{cite journal| author=Brown J, Farquhar C, Lee O, Toomath R, Jepson RG| title=Spironolactone versus placebo or in combination with steroids for hirsutism and/or acne. | journal=Cochrane Database Syst Rev | year= 2009 | volume= | issue= 2 | pages= CD000194 | pmid=19370553 | * [[Hirsutism]]<ref name="pmid19370553">{{cite journal| author=Brown J, Farquhar C, Lee O, Toomath R, Jepson RG| title=Spironolactone versus placebo or in combination with steroids for hirsutism and/or acne. | journal=Cochrane Database Syst Rev | year= 2009 | volume= | issue= 2 | pages= CD000194 | pmid=19370553 | ||
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&email=badgett@uthscdsa.edu&retmode=ref&cmd=prlinks&id=19370553 | doi=10.1002/14651858.CD000194.pub2 }}</ref> | | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&email=badgett@uthscdsa.edu&retmode=ref&cmd=prlinks&id=19370553 | doi=10.1002/14651858.CD000194.pub2 }}</ref> |
Revision as of 22:48, 20 February 2011
In pharmacology, aldosterone antagonists are "compounds which inhibit or antagonize the biosynthesis or actions of aldosterone."[1] Their actions affect the larger renin-angiotensin system.
Availability
Drug | Size | Cost per 90 pills |
---|---|---|
Eplerenone (Inspra brand) | 50 mg | $405.09 |
Eplerenone (generic) | 50 mg | $275.99 |
Spironolactone (Aldactone brand) | 25 mg | $96.97 |
Spironolactone (generic) | 25 mg | $29.97 |
- Canrenone
- Drospirenone
- Eplerenone. Compared to spironolactone, eplerenone is eplerenone is more selective the mineralocorticoid receptor than than androgen and progesterone receptors.[2]
- Spironolactone
Uses
- Ascites
- Chronic kidney disease[3]
- Hirsutism[4]
- Hypertension
- Prevention of hypokalemia caused by thiazide diuretic therapy
Heart failure
Trial | Patients | Intervention | Comparison | Outcome | Results | ||
---|---|---|---|---|---|---|---|
Intervention | Control | ||||||
EMPHASIS-HF[5] 2010 |
cell | eplerenone up to 50 mg/day | Placebo | cell | cell | cell | |
EPHESUS[2] 2003 |
6642 patients • ≤ 2 weeks after myocardial infarction • ≤ 40 percent ejection fraction |
eplerenone up to 50 mg/day | Placebo | mortality at 24 months | 14% | 17% | P=0.008 |
RALES[6] 1999 |
cell | spironolactone 25 mg/day | Placebo | cell | cell | cell |
Side effects
References
- ↑ Anonymous (2024), Aldosterone antagonist (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ 2.0 2.1 Pitt B, Remme W, Zannad F, Neaton J, Martinez F, Roniker B et al. (2003). "Eplerenone, a selective aldosterone blocker, in patients with left ventricular dysfunction after myocardial infarction.". N Engl J Med 348 (14): 1309-21. DOI:10.1056/NEJMoa030207. PMID 12668699. Research Blogging. Review in: J Fam Pract. 2003 Aug;52(8):598-9 Review in: ACP J Club. 2003 Sep-Oct;139(2):32
- ↑ Navaneethan SD, Nigwekar SU, Sehgal AR, Strippoli GF (2009). "Aldosterone antagonists for preventing the progression of chronic kidney disease.". Cochrane Database Syst Rev (3): CD007004. DOI:10.1002/14651858.CD007004.pub2. PMID 19588415. Research Blogging.
- ↑ Brown J, Farquhar C, Lee O, Toomath R, Jepson RG (2009). "Spironolactone versus placebo or in combination with steroids for hirsutism and/or acne.". Cochrane Database Syst Rev (2): CD000194. DOI:10.1002/14651858.CD000194.pub2. PMID 19370553. Research Blogging.
- ↑ Zannad F, McMurray JJ, Krum H, van Veldhuisen DJ, Swedberg K, Shi H et al. (2011). "Eplerenone in patients with systolic heart failure and mild symptoms.". N Engl J Med 364 (1): 11-21. DOI:10.1056/NEJMoa1009492. PMID 21073363. Research Blogging.
- ↑ Pitt B, Zannad F, Remme WJ, Cody R, Castaigne A, Perez A et al. (1999). "The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators.". N Engl J Med 341 (10): 709-17. DOI:10.1056/NEJM199909023411001. PMID 10471456. Research Blogging.