Drug interactions
amiodarone + eplerenone
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Overview
Amiodarone can increase eplerenone exposure via CYP3A4 inhibition, raising hyperkalemia risk; eplerenone dose limits apply with moderate CYP3A4 inhibitors.
Mechanism of action
CYP3A4 inhibition by amiodarone → ↑ eplerenone concentrations → ↑ potassium.
Clinical management
Avoid combination if possible. If necessary, do not exceed eplerenone 25 mg once daily; check K and renal function at baseline, within 1 week, then regularly; hold eplerenone if K>5.5 mEq/L.
Drug reference
References
- Inspra (eplerenone) Prescribing Information — FDA Label
- Lexicomp Drug Interactions (eplerenone; amiodarone/CYP3A4 inhibitors) — Lexicomp
Frequently asked questions
Can I take amiodarone with eplerenone?
The interaction is rated: Major. Amiodarone can increase eplerenone exposure via CYP3A4 inhibition, raising hyperkalemia risk; eplerenone dose limits apply with moderate CYP3A4 inhibitors.
How serious is the interaction between amiodarone and eplerenone?
The interaction is rated: Major. Evidence level: Moderate.
How is the interaction between amiodarone and eplerenone managed?
Avoid combination if possible. If necessary, do not exceed eplerenone 25 mg once daily; check K and renal function at baseline, within 1 week, then regularly; hold eplerenone if K>5.5 mEq/L.
Why do amiodarone and eplerenone interact?
CYP3A4 inhibition by amiodarone → ↑ eplerenone concentrations → ↑ potassium.
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