Inspra is an improved version of spironolactone, which is available as a cheap generic.

FORBES: Pfizer's Heart Failure Flop

In big clinical trials, both spironolactone and Inspra were shown to improve the survival of heart failure patients.

FORBES: Pfizer's Heart Failure Flop

The study advocates watching patients more closely and using spironolactone more judiciously.

FORBES: Pfizer's Heart Failure Flop

But in yesterday's issue of The New England Journal of Medicine, researchers published a study showing that patients on spironolactone were more likely to die from hyperkalemia.

FORBES: Pfizer's Heart Failure Flop

But spironolactone, unlike Inspra, can cause impotence and breast tenderness.

FORBES: Pharmacia's Inspra Rationale

But an editorial in the New England Journal said that Inspra might be too expensive to use in patients who had not already tried spironolactone, a cheap generic drug.

FORBES: Pharmacia's Inspra Rationale

Doctors may feel the drug provides little extra benefit compared with an existing heart failure drug, spironolactone, for a much higher cost, notes Eric Topol, chairman of cardiovascular medicine at the Cleveland Clinic.

FORBES: Pfizer's Heart Failure Flop