Drug interactions
Eplerenone + Istradefylline
Severity: Moderate
Eplerenone and Istradefylline: moderate interaction.
Last updated
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.
Summary
At 40 mg daily, istradefylline increases exposure to CYP3A4 substrates, which may raise eplerenone levels and the risk of hyperkalemia. This effect was not seen at 20 mg daily.
What this interaction means in plain words
Eplerenone and Istradefylline can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Eplerenone belongs to Cardiovascular; Istradefylline belongs to Central Nervous System.
Why it happens
Dose-dependent CYP3A4 inhibition by istradefylline reduces eplerenone metabolism.
What to do
Monitor serum potassium and consider reducing the eplerenone dose if istradefylline 40 mg daily is used.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Eplerenone
- Amiloride + Eplerenone Contraindicated
- Atazanavir + Eplerenone Contraindicated
- Clarithromycin + Eplerenone Contraindicated
- Cobicistat + Eplerenone Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Eplerenone Contraindicated
- Ensitrelvir + Eplerenone Contraindicated
Other interactions of Istradefylline
Frequently asked questions
Can I take Eplerenone with Istradefylline?
MediHelp rates the interaction as moderate. Eplerenone and Istradefylline can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. At 40 mg daily, istradefylline increases exposure to CYP3A4 substrates, which may raise eplerenone levels and the risk of hyperkalemia. This effect was not seen at 20 mg daily.
How serious is the interaction between Eplerenone and Istradefylline?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor serum potassium and consider reducing the eplerenone dose if istradefylline 40 mg daily is used.
What other medicines interact with Eplerenone?
MediHelp also lists interactions of Eplerenone with, for example, Amiloride, Atazanavir, Clarithromycin. The full list is on the Eplerenone page.
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