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A Medline search identified clinical studies assessing spironolactone and eplerenone. Priority was given to large, well\u2010controlled, clinical trials and comparative studies. Pharmacological differences between spironolactone and eplerenone include lower affinity of eplerenone for progesterone, androgen, and glucocorticoid receptors; more consistently demonstrated nongenomic properties for eplerenone; and the presence of long\u2010acting metabolites for spironolactone. Both agents effectively treat hypertension and heart failure but comparisons are complicated by the deficiency of head\u2010to\u2010head trials and differences between patient populations. There are differences in the tolerability profiles; spironolactone is associated with dose\u2010dependent sexual side effects. Both agents produce dose\u2010dependent increases in potassium concentrations, although the effect with spironolactone appears to be greater when both agents are administered at recommended doses. Choice of a specific agent should be based on individual patient issues, such as the nature of heart failure and patient concerns about adverse events. Copyright \u00a9 2008 Wiley Periodicals, Inc.<\/jats:p>","DOI":"10.1002\/clc.20324","type":"journal-article","created":{"date-parts":[[2008,4,10]],"date-time":"2008-04-10T20:46:38Z","timestamp":1207860398000},"page":"153-158","source":"Crossref","is-referenced-by-count":221,"title":["A Comparison of the Aldosterone\u2010blocking Agents Eplerenone and Spironolactone"],"prefix":"10.1002","volume":"31","author":[{"given":"Allan","family":"Struthers","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry","family":"Krum","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gordon 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