Both agents obstruct the aldosterone receptor, however, spironolactone has progestogenic and antiandrogenic actions, effects that are reduced in eplerenone. So far, the incidence of adverse consequences with eplerenone has been slightly lower than with spironolactone. Study selection and data extraction: Studies and review articles related to eplerenone, aldosterone, aldosterone antagonist, and spironolactone were also evaluated. Animal studies with eplerenone have shown a positive function in aldosterone antagonism in the treatment of hypertension, diabetes, heart failure, myocardial infarction, renal disease, and atherosclerosis. Conclusions: Eplerenone appears to be a promising drug in a new class of agents known as selective aldosterone blockers. The drug may be approved for treatment of hypertension in 2002. Further studies are continuing that may provide information on other clinical applications for this medication. 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