Pharmacovigilance Profiles of Three Generations of Mineralocorticoid Receptor Antagonists and Network Toxicology Analysis

This study analyzed 11,556 reports from the FAERS database to assess the safety profiles of three mineralocorticoid receptor antagonists: spironolactone, eplerenone, and finerenone. Spironolactone exhibited the broadest range of adverse events, including hyperkalemia and acute kidney injury, with significant teratogenic and toxicity risks. Eplerenone was associated with serious cardiac and renal events, while finerenone's adverse events were primarily renal and metabolic. Hyperkalemia was a common issue across all drugs. The study highlights the need for personalized safety monitoring and further validation, as the findings are hypothesis-generating rather than definitive.