Chronic Kidney Disease Associated with Type 2 Diabetes
- PO (Adults ): 20 mg once daily.
Renal Impairment
- PO (Adults ): eGFR 25–<60 mL/min/m2: 10 mg once daily; after 4 wk, ↑ to 20 mg once daily if serum potassium ≤ 4.8 mEq/L.
Heart Failure with Left Ventricular Ejection Fraction 40%
- PO (Adults ): 20 mg once daily; after 4 wk, ↑ to 40 mg once daily if serum potassium <5 mEq/L.
Renal Impairment
- PO (Adults ): eGFR 25–<60 mL/min/m2: 10 mg once daily; after 4 wk, ↑ to 20 mg once daily if serum potassium <5 mEq/L.
Therapeutic Classification: none assigned
Pharmacologic Classification: mineralocorticoid receptor antagonists non steroidal
Absorption: 44% absorbed following oral administration.
Distribution: Widely distributed to tissues.
Protein Binding: 92%.
Metabolism/Excretion: Primarily metabolized in the liver via the CYP3A4 isoenzyme and to a lesser extent by the CYP2C8 isoenzyme to inactive metabolites. Primarily excreted in the urine (80%) as metabolites, with 20% being excreted in feces.
Half-Life: 2–3 hr.
