Indications
Esaxerenone is used to treat high blood pressure (hypertension) in adults. Lowering blood pressure reduces the risk of stroke, heart attack, heart failure and kidney damage.
How It Works
Esaxerenone is a non-steroidal mineralocorticoid receptor blocker. It blocks the action of aldosterone, a hormone that makes the kidneys hold on to salt and water and can damage the heart and blood vessels. Blocking aldosterone helps the body lose extra salt and water and relaxes the blood vessels, so blood pressure falls.
Dosage and Administration
The usual adult starting dose is 2.5 mg once daily by mouth, which the doctor may increase to 5 mg once daily if needed. People with reduced kidney function or diabetes with protein in the urine may start at 1.25 mg once daily. Take it as prescribed, at the same time each day, with or without food.
- Blood potassium and kidney function should be checked before starting, a few weeks after starting or changing the dose, and regularly afterwards.
Interactions
Do not take it with potassium supplements or potassium-sparing diuretics such as Spironolactone, Eplerenone, Amiloride or Triamterene, because potassium can rise to dangerous levels. Extra care is needed with ACE inhibitors (such as Enalapril), ARBs (such as Losartan), Trimethoprim and NSAIDs. Strong enzyme inhibitors such as Itraconazole or Clarithromycin raise its levels, and Rifampicin or Carbamazepine lower them. Lithium levels may increase. Avoid salt substitutes that contain potassium.
Contraindications
- Allergy to Esaxerenone.
- High blood potassium (above 5.0 mmol/L) before starting.
- Severe kidney impairment.
- Use with potassium supplements or potassium-sparing diuretics.
Side Effects
The most important side effect is high blood potassium (hyperkalaemia). Other effects include dizziness, low blood pressure, headache and a rise in blood creatinine (a kidney test).
Get urgent medical help if you have muscle weakness, numbness or tingling, a slow or irregular heartbeat, chest discomfort, fainting, or signs of an allergic reaction such as swelling of the face or difficulty breathing.
Pregnancy and Lactation
Not recommended during pregnancy; tell your doctor if you are pregnant or planning pregnancy, so another blood pressure medicine can be chosen. Avoid breastfeeding while taking it, as safety for the baby is not established.
Precautions and Warnings
Use with care in people with kidney disease, diabetes, liver disease, dehydration and older adults, who have a higher risk of high potassium. Tell your doctor if you develop vomiting, diarrhoea or poor fluid intake. Dizziness may occur when starting, so take care when driving.
Overdose
Overdose may cause low blood pressure and high blood potassium. Seek emergency medical help. Treatment includes monitoring of blood potassium and the heart and supportive care.
Therapeutic Class
Antihypertensive, non-steroidal mineralocorticoid receptor antagonist.
Storage
Store below 30°C in a dry place, away from light and out of the reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.