Mineralocorticoid antagonist
Mineralocorticoid receptor antagonist
- ↓ aldosterone action → sodium loss, potassium retention
- BP lowering, heart-failure survival benefit, and diuresis
- Hyperkalemia is the principal risk
- Potassium-sparing diuresis; mortality benefit in heart failure
- Hyperkalemia is the principal danger
Drugs with this mechanism (5)
- Drospirenone — Antimineralocorticoid progestin used in contraceptives.
- Eplerenone — Selective mineralocorticoid antagonist; less gynecomastia than spironolactone.
- Finerenone — Nonsteroidal MRA with renal and cardiovascular benefit in diabetic kidney disease.
- Spironolactone — Aldosterone antagonist; heart-failure survival, acne, and gynecomastia.
- Vamorolone — Dissociative glucocorticoid-receptor modulator for Duchenne dystrophy; still suppresses the adrenal axis.
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