Drug interactions
Eplerenone + Telmisartan
Severity: Major
Eplerenone and Telmisartan: major interaction.
Last updated Sources: US FDA label
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
Eplerenone blocks mineralocorticoid receptors and telmisartan blocks angiotensin II receptors, and both reduce aldosterone effect on potassium excretion. Together they can cause clinically significant hyperkalemia, especially in renal impairment, diabetes or older patients.
What this interaction means in plain words
Eplerenone and Telmisartan can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Eplerenone belongs to Cardiovascular; Telmisartan belongs to Cardiovascular.
Why it happens
Additive suppression of aldosterone-mediated renal potassium excretion.
What to do
Check serum potassium and renal function at baseline, within the first week or so, and periodically afterwards. Reduce or stop one agent if potassium rises significantly, and avoid potassium supplements.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
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 Telmisartan
- Aliskiren + Telmisartan Contraindicated
- Sparsentan + Telmisartan Contraindicated
- Amifostine + Telmisartan Major
- Amiloride + Telmisartan Major
- Amlodipine-benazepril + Telmisartan Major
- Amlodipine-hydrochlorothiazide-valsartan + Telmisartan Major
Frequently asked questions
Can I take Eplerenone with Telmisartan?
MediHelp rates the interaction as major. Eplerenone and Telmisartan can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Eplerenone blocks mineralocorticoid receptors and telmisartan blocks angiotensin II receptors, and both reduce aldosterone effect on potassium excretion. Together they can cause clinically significant hyperkalemia, especially in renal impairment, diabetes or older patients.
How serious is the interaction between Eplerenone and Telmisartan?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Check serum potassium and renal function at baseline, within the first week or so, and periodically afterwards. Reduce or stop one agent if potassium rises significantly, and avoid potassium supplements.
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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