muscled guy sitting curlingEplerenone is a next-generation mineralocorticoid antagonist. Like spironolactone it acts as a diuretic and helps to prevent mineralocorticoid-induced cardiovascular damage and reduces high blood pressure. Like spironolactone, eplerenone can cause a dangerous build-up of potassium in the blood (called hyperkalemia) so extreme care must be taken when using these drugs. Unlike spironolactone, eplerenone has no antagonist activity at the androgen receptor so it is unlikely to cause gynecomastia. Eplerenone is virtually unknown in the steroid using public because it is very new and is not available in generic form. Epleronone has distinct advantages over spironolactone but like other brand name only medications, is much more expensive than the readily available generic versions of spironolactone. The inhibition of 11-beta hydroxylase by certain AAS results in elevated levels of deoxycorticosterone in the blood. Deoxycorticosterone is a mineralocorticoid and will result in sodium and water retention, high blood pressure and adverse cardiovascular effects. Employing a mineralocorticoid antagonist could, theoretically, reduce these side effects of those AAS that inhibit 11-beta hydroxylase. The largest concern in doing so would be the potential for hyperkalemia with the use of antimineralocorticoids since some AAS have been reported to cause potassium retention as well.

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