Description:

Eplerenone Tablets 25mg and 50mg (by Crescent) are selective mineralocorticoid receptor antagonists (aldosterone blockers) used primarily to treat chronic heart failure with reduced ejection fraction (after myocardial infarction) and essential hypertension. They reduce mortality and hospitalization risk in heart failure by blocking aldosterone effects, which helps prevent cardiac remodeling, sodium retention, and fluid overload. They are also used for blood pressure control when other agents are insufficient. In Ghana (Accra), they are a prescription medication commonly available in pharmacies for heart failure and resistant hypertension management.

Prescription:

Prescription-only (requires a doctor’s prescription in Ghana; dispensed by pharmacies with Rx; typically prescribed by cardiologists or physicians after assessing renal function, potassium levels, and heart failure status; not OTC due to hyperkalaemia risk and need for regular monitoring).

Therapeutic Category:

Selective Aldosterone Receptor Antagonist / Potassium-Sparing Diuretic (Cardioprotective antihypertensive).

Active Ingredients/Composition: Each film-coated tablet contains:

• Active ingredient: Eplerenone – 25 mg or 50 mg per tablet. Other ingredients (excipients, typical): Lactose monohydrate, microcrystalline cellulose, croscarmellose sodium, hypromellose, magnesium stearate, titanium dioxide, talc, macrogol, iron oxides (for coloring – 25mg often yellow, 50mg pink). Tablets are film-coated, oval/biconvex, and debossed with strength.

Vitamins: None.

Minerals: None.

Variant:

• Eplerenone 25mg film-coated tablets (lower dose for initiation or patients with renal impairment).
• Eplerenone 50mg film-coated tablets (standard maintenance dose). Common pack size: 28 tablets (most frequent), 30 tablets, or 60 tablets. The two strengths are the main variants.

Consume Type:

Oral – Film-coated tablet (swallow whole with water; do not crush or chew).

Directions/Usage: Take as prescribed (usually once daily).

• Heart failure post-MI: Start at 25mg once daily; increase to 50mg once daily after 4 weeks if tolerated (serum potassium <5.0 mmol/L and creatinine <2.5 mg/dL in men / <2.0 mg/dL in women).
• Hypertension: 50mg once daily; may increase to 50mg twice daily if needed (max 100mg/day).
• Take at the same time each day, with or without food.
• Duration: Long-term (often lifelong) for heart failure/hypertension; do not stop suddenly without medical advice.
• Regular monitoring of serum potassium, creatinine, and eGFR required (especially first weeks and after dose changes).

Common Side Effects: Common:

• Hyperkalemia (high potassium – most important; monitor closely).
• Dizziness, headache.
• Fatigue, weakness.
• Diarrhea, abdominal pain.
• Increased creatinine (renal function changes). Rare/serious (seek immediate help): Severe hyperkalaemia (muscle weakness, arrhythmias), acute kidney injury, severe allergic reactions, or gynecomastia (rare compared to spironolactone).

Package Type:

Blister packs (typically 28 tablets per pack; 4×7 or 2×14 foil blisters in carton with patient information leaflet and dosing guide).

Storage Advice: Store at room temperature (below 25–30°C) in original packaging, protected from moisture and light. Keep tightly closed. Out of reach of children.

Safety Advice:

• Contraindicated in hyperkalemia (>5.0 mmol/L at initiation), severe renal impairment (eGFR <30 mL/min/1.73m²), severe hepatic impairment, or concomitant use of strong CYP3A4 inhibitors (e.g., ketoconazole, itraconazole, ritonavir).
• Caution in mild-moderate renal/hepatic impairment (monitor closely), diabetes (higher hyperkalemia risk), or concurrent use of ACE inhibitors/ARBs/NSAIDs/potassium-sparing diuretics (increased hyperkalemia risk).
• Do not use potassium supplements or salt substitutes containing potassium unless monitored.
• Monitor serum potassium and renal function within 1 week of starting and after dose changes.
• If muscle weakness, irregular heartbeat, severe fatigue, or reduced urine output occurs, seek immediate care (hyperkalemia or kidney injury).
• Keep out of reach of children (overdose risk).

Product Substitutes: Similar eplerenone tablets in Ghana include:

• Generic eplerenone 25mg and 50mg film-coated tablets (various importers).
• Inspra (original Pfizer brand, higher price if stocked).
• Other brands like Eplerenone Sandoz, Eplerox, or local generics. Alternatives: Spironolactone (Aldactone – non-selective aldosterone antagonist, cheaper but more gynecomastia risk). Consult cardiologist/physician in Accra for alternatives.

Manufacturer/Marketer:

Crescent Pharmaceuticals or Crescent Therapeutics (India-based; produces generic eplerenone under various brand names for export markets). Marketed/distributed in Ghana by local importers/pharmacies (widely stocked as imported generic).

Country of Origin:

India (manufactured by Crescent Pharmaceuticals or similar Indian company; imported to Ghana and available in local pharmacies).