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Adverse Effects of Mineralocorticoid Receptor Antagonist Administration

Author(s):

Manolis S. Kallistratos*, Andreas Pittaras, Iakovos Theodoulidis, Charris Grassos, Leonidas E. Poulimenos and Athanasios J. Manolis   Pages 1 - 5 ( 5 )

Abstract:


Background: Mineralocorticoid receptor antagonists consist a class of drugs with pleiotropic beneficial effects in several cardiovascular diseases. However, physicians frequently overlook their use due to the adverse effects of such agents.

Objectives: To determine the adverse effects of mineralocorticoid receptor antagonists and to suggest clinically meaningful options. We present data on the two most administered agents of this class: spironolactone and eplerenone.

Method: We conducted an in-depth review of the existing international literature to draft a mini review about the mineralocorticoid receptor antagonists-related side effects.

Result: Mineralocorticoid receptor antagonists are associated with increased risk of hyperkalemia and acute deterioration of renal function. Of note, these adverse effects are dose dependent, more common during the initial period of treatment, and are usually reversed after the withdrawal of therapy. Sex-related adverse events are noted mainly in spironolactone, while switching to eplerenone could attenuate those.

Conclusion: Mineralocorticoid receptor antagonists therapy is significantly limited due to their side effects. The development of novel non-steroidal mineralocorticoid receptor antagonists could substantially widen the use of such agents.

Keywords:

mineralocorticoid receptor antagonist, spironolactone, eplerenone, hyperkalemia, acute kidney injury, adverse event

Affiliation:

Cardiology Department, Asklepieion General Hospital, Athens, Cardiology Department, Asklepieion General Hospital, Athens, First Department of Obstetrics and Gynaecology, Aristotle University, Thessaloniki, Department of Cardiology, Hypertension Excellence Centre-ESH, KAT General Hospital, Athens, Cardiology Department, Asklepieion General Hospital, Athens, Cardiology Department, Asklepieion General Hospital, Athens



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