Eplerenone

A mineralocorticoid receptor blocker, FDA-approved for heart failure with reduced ejection fraction after a heart attack and for hypertension.

psilodex.org/m/eplerenone · data v2026.10.05

Clinical contraindication: None listed; No label contraindication covering psilocybin was found. This is not a finding that the combination has been shown to be without risk.
Psilocybin evidence: No psilocybin data
Half-life: ~3–6 h; Approximate, in adults. Source under Interaction below.

Named in state rules?

Not namedColorado Condition rules (3)

Not namedOregon

PendingNew Mexico

Cite asPsilodex, “Eplerenone”, v2026.10.05. psilodex.org/m/eplerenone

Clinical data and state rules are separate facts. Both are shown; neither is a decision.

What it is used for

FDA status

FDA-approved

FDA-approved for

Heart failure with reduced ejection fraction after a heart attack (to improve survival)
High blood pressure (hypertension)

Sources [1]

01 Interaction with psilocybin

It lowers blood pressure, so it may lessen psilocybin's brief blood pressure rise; it is not expected to change how the body clears psilocybin.

Detail Eplerenone lowers blood pressure, so it may lessen psilocybin's brief blood pressure rise (no psilocybin data). The liver enzyme CYP3A4 breaks it down. Its label states it does not inhibit CYP3A4 or CYP2D6, so no effect on psilocin's clearance is expected. Separately, high potassium is its main labeled risk. Sources [1]

Human data with psilocybin: No psilocybin data; based on how it works and its label
Half-life: ~3–6 h (FDA label, checked 2026-10-04)

Evidence types on this record

No psilocybin dataNo psilocybin data: no human data with psilocybin or another classic psychedelic; the text draws on the medication's own pharmacology and its label or reference facts

02 Pharmacology relevant to psilocybin

2 listed · counted on reports

Dehydration or electrolyte risk: Can cause dehydration or shifts in sodium or potassium. Sources [1]
Lowers blood pressure or causes orthostasis: Lowers blood pressure, or causes a drop on standing (orthostasis) that can bring dizziness or fainting. Sources [1]

03 State rules

Plain-language summary · official text governs

CO4 CCR 755-1

Not namedCondition rules (3)

No provision names this medication or its class.

Colorado · checked 2026-10-04

OROAR 333-333

Not named

No provision names this medication or its class.

Oregon · checked 2026-10-04

NM7.35.3 NMAC (proposed)

Pending

New Mexico's clinical rules (proposed 7.35.3 NMAC) are not final. No provision naming this medication has been found.

New Mexico · checked 2026-10-04

04 Conditions to ask about

Screening items in state rules

This medication is usually taken for a condition. State rules screen for some conditions directly, so the medication is a prompt to ask about them. Confirm with the participant; never assume a condition from the medication.

Hypertension (provision applies if uncontrolled)
- CO 2.5(A)(2) · Clinical Facilitator licensees
- CO 6.16(F)(2)(a) · Facilitators without a clinical facilitator license
- CO 6.16(F)(1) · All licensees
Heart failure or past heart attack
- CO 2.5(A)(2) · Clinical Facilitator licensees
- CO 6.16(F)(2)(a) · Facilitators without a clinical facilitator license
- CO 6.16(F)(1) · All licensees

05 Sources

INSPRA (eplerenone) tablets · FDA label (DailyMed) — Dehydration or electrolyte risk: 5.1 Hyperkalemia "The risk of hyperkalemia is higher in patients with impaired renal function, proteinuria, diabetes and those concomitantly treated with ACEs, ARBs, NSAIDs and moderate CYP3A inhibitors." | Lowers blood pressure or causes orthostasis: 1.2 Hypertension "INSPRA is indicated for the treatment of hypertension in adults, to lower blood pressure." | 12.3 Drug-Drug Interactions "Eplerenone is not an inhibitor of CYP1A2, CYP3A4, CYP2C19, CYP2C9, or CYP2D6." | 12.3 Pharmacokinetics "The elimination half-life of eplerenone is approximately 3 to 6 hours." | revised 2025-06

Record history

v2026.10.02First published.
2026-10-04Last reviewed against its sources.

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