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Adverse Effects of Mineralocorticoid Receptor Antagonist Administration

[ Vol. 24 , Issue. 46 ]

Author(s):

Manolis S. Kallistratos*, Andreas Pittaras, Iakovos Theodoulidis, Charris Grassos, Leonidas E. Poulimenos and Athanasios J. Manolis   Pages 5537 - 5541 ( 5 )

Abstract:


Background: Mineralocorticoid receptor antagonists consist of 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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