Eplerenone is contraindicated in all patients with the following: Hypersensitivity to eplerenone or any component of this medication.
Clinically significant hyperkalemia or with conditions associated with hyperkalemia.
Serum potassium level >5.0 mmol/L (mEq/L) at initiation.
Moderate to severe renal impairment (creatinine clearance <50 mL/min) in post-MI heart failure (Eplerenone Post-acute Myocardial Infarction Heart failure Efficacy and Survival Study [EPHESUS]).
Severe hepatic impairment (Child-Pugh Class C).
Concomitant use with potassium-sparing diuretics, or potent inhibitors of CYP450 3A4 such as ketoconazole, itraconazole, and ritonavir (see Interactions).