Aldosterone receptor blockers spironolactone and canrenone: Two multivalent drugs
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Canrenone is a derivative of spironolactone with lower antiandrogen activity. The drug is used only in few countries and can block all the side effects of aldosterone (ALDO). The drug is effective even in the presence of normal concentrations of ALDO. Mineralcorticoid receptor antagonists block the inflammatory activity of ALDO at the level of target tissues as heart, vessels and mononuclear leukocytes. Canrenone reduces the progression of insulin resistance and of microalbuminuria in type 2 diabetes and other related diseases. Both canrenone and hydrochlorothiazide can enhance the effect of treatment with ACE inhibitors and angiotensin II receptor blockers on microalbuminuria, but ALDO receptor blockers are more active. This different action is due to the fact that only canrenone blocks mineralocorticoid receptors. Serum potassium and renal function should be monitored before and during the treatment. ALDO receptor blockers are recommended in addition to polytherapy for resistant hypertension, but there are no studies on the effect of the drug as first-choice therapy.
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Spironolactone is a mineralocorticoid receptor antagonist.
“In addition, spironolactone is a mineralocorticoid receptor antagonist and its use as monotherapy or in addition to COCs has been proposed to reduce side effects related to RAAS activation in PCOS, particularly the pro-inflammatory status, some metabolic alterations, and hypertension [74].”
From Controversies in the Pathogenesis, Diagnosis and Treatment of PCOS: Focus on Insulin Resistance, Inflammation, and Hyperandrogenism (2022) · cites this paper as [74]
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- Authors
- Armanini, D., Sabbadin, C., Donà, G., Clari, G., & Bordin, L.
- Affiliations
- University of Padua (IT)
- Venue
- Expert Opinion on Pharmacotherapy
- Publisher
- Informa Healthcare
- Published
- 2014-03-11
- Volume
- 15
- Issue
- 7
- Pages
- 909-912
- ISSN
- 1465-6566 (ISSN-L)
- 1744-7666
- OpenAlex
- W2130500198
- Cited by
- 41
- References
- 17
- Citations by year
- 2025: 4 · 2024: 3 · 2023: 1 · 2022: 2 · 2021: 3 · 2020: 6 · 2019: 4 · 2018: 4 · 2017: 7 · 2016: 4 · 2015: 2 · 2014: 1
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Expert Opinion on Pharmacotherapy (publishedVersion)
- PubMed (publishedVersion)
- Padua Research Archive (University of Padova) (submittedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Renin-Angiotensin System Studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Keywords
- canrenone, spironolactone, aldosterone receptor blockers, mineralocorticoid receptor antagonists, microalbuminuria, insulin resistance, type 2 diabetes, resistant hypertension, ACE inhibitors, angiotensin receptor blockers, serum potassium, renal function
- MeSH terms
- Albuminuria, Aldosterone, Mineralocorticoid Receptor Antagonists, Angiotensin-Converting Enzyme Inhibitors, Canrenone, Humans, Hypertension, Inflammation, Insulin Resistance, Spironolactone
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