Influence of acetylsalicylic acid on the renal handling of a spironolactone metabolite in healthy subjects

Ramsay, L. E.; Harrison, I. R.; Shelton, J. R.; Vose, C. W.

doi:10.1007/bf00561548

Cited by 12 publications

(5 citation statements)

References 14 publications

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“…This finding was confirmed by giving a single oral dose of 600 mg aspirin together with spironolactone (20-100 mg) to ten healthy male physicians (TWEED DALE and OGILVIE 1973) and six male volunteers (RAMSAY et al 1976). Since the reductions in urinary canrenone excretion correlated with its distal tubule effects, canrenone may be actively secreted at the proximal tubule, and this secretion is blocked by aspirin (or its conjugates) (RAMSAY et al 1976; see also Chap.…”

Section: Aspirinmentioning

confidence: 73%

Diuretics

1995

Handbook of Experimental Pharmacology

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Section: Aspirinmentioning

confidence: 73%

Diuretics

1995

Handbook of Experimental Pharmacology

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“…Mineralocorticoid receptor antagonists (MRAs) reduced morbidity and mortality in several landmark studies . Pharmacological interactions between aspirin and the MRA spironolactone have been described previously . Spironolactone was reported to increase reno‐medullary prostaglandin synthesis .…”

Section: Introductionmentioning

confidence: 95%

“…Spironolactone was reported to increase reno‐medullary prostaglandin synthesis . Aspirin has been reported to decrease the natriuretic effect of spironolactone, possibly through active competition for the renal tubular secretion mechanism or mineralocorticoid receptor blockade . Therefore, a clinically meaningful adverse interaction between aspirin and MRAs is theoretically plausible and could potentially lead to detrimental outcomes in HF patients.…”

Section: Introductionmentioning

confidence: 99%

Aspirin does not reduce the clinical benefits of the mineralocorticoid receptor antagonist eplerenone in patients with systolic heart failure and mild symptoms: an analysis of the EMPHASIS‐HF study

Chin

Collier

Pitt

et al. 2016

European J of Heart Fail

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AimsIt is not known whether concomitant use of aspirin might attenuate the beneficial effects of mineralocorticoid receptor antagonists (MRAs). The purpose of this subgroup analysis was to explore the interaction between baseline aspirin treatment and the effect of eplerenone on the primary efficacy outcomes (composite of hospitalization for heart failure or cardiovascular mortality), its components, and safety markers [estimated glomerular filtration rate (eGFR), systolic blood pressure (SBP), and serum potassium >5. Methods and resultsPatients with chronic heart failure, reduced ejection fraction (HFREF), and mild symptoms were enrolled in EMPHASIS-HF. We evaluated baseline characteristics according to aspirin use. We explored the interaction between aspirin and eplerenone, using Cox proportional hazards models providing adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) and P-values for interaction. Of the 2737 patients randomized, 1605 patients (58.6%) were taking aspirin. The beneficial effects of eplerenone on the primary endpoint were similar in patients not treated (adjusted HR 0.59, 95% CI 0.46-0.75) or treated (adjusted HR 0.71, 95% CI 0.59-0.87) with aspirin at baseline (interaction P-value = 0.19).

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“…Фармакологическое взаимодействие между АСК и АМКР было описано ранее [31][32][33]. Имеются данные о том, что спиронолактон приводит к увеличению синтеза простагландинов в мозговом слое надпочечников [31].…”

Section: данные об отсутствии снижения эффективности применения эплерunclassified

“…Имеются данные о том, что спиронолактон приводит к увеличению синтеза простагландинов в мозговом слое надпочечников [31]. Сообщалось, что АСК приводит к уменьшению выраженности натрийуретического эффекта спиронолактона, возможно, за счет активной конкуренции с механизмами секреции в почечных канальцах или блокадой минералокортикоидных рецепторов [31][32][33]. Следовательно, клинически значимое взаимодействие между АСК и АМКР теоретически представляется возможным, и может приводить к ухудшению клинических исходов у больных с СН.…”

Section: данные об отсутствии снижения эффективности применения эплерunclassified

New Clinical Aspects of Eplerenone Use in Clinical Practice

Gilyarevskiy

Бенделиани

Голшмид

et al. 2018

Racionalʹnaâ farmakoterapiâ v kardiologii

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The problem of the discrepancy between convincing evidences of the effectiveness of the use of mineralocorticoid receptor antagonists in patients with heart failure with reduced left ventricular ejection fraction and insufficiently frequent their use in clinical practice for the treatment of these patients is considered in the article. Experts opinions on the reasons for this discrepancy are also presented. New data on the effectiveness of the use of the mineralocorticoid receptor antagonist, eplerenone, in some clinical situations identified in the analysis of subgroups of participants in a large randomized clinical trial EMPHASIS-HF are discussed. The main goal of this study was to evaluate the efficacy of eplerenone compared with placebo in patients with heart failure and reduced left ventricular function. In addition, experimental animal studies, which may indicate the pleiotropic effects of eplerenone in patients with vascular diseases, are presented. The new data on the effectiveness of eplerenone in subgroups of patients with heart failure and certain characteristics may be an additional reason to draw the attention of physicians to the benefits of its use and, accordingly, its more frequent application in clinical practice for the treatment of patients with clear indications for this therapy.

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Influence of acetylsalicylic acid on the renal handling of a spironolactone metabolite in healthy subjects

Cited by 12 publications

References 14 publications

Diuretics

Diuretics

Aspirin does not reduce the clinical benefits of the mineralocorticoid receptor antagonist eplerenone in patients with systolic heart failure and mild symptoms: an analysis of the EMPHASIS‐HF study

New Clinical Aspects of Eplerenone Use in Clinical Practice

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