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A combination therapy consisting of spironolactone, a mineralocorticoid receptor antagonist, and dapagliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor. This combination has shown effectiveness in treating heart failure with preserved ejection fraction (HFpEF) and heart failure with mildly reduced ejection fraction (HFmrEF). Spironolactone acts by blocking aldosterone receptors in the distal tubules, causing increased sodium and water excretion while retaining potassium. Dapagliflozin works by inhibiting SGLT2 in the proximal tubule of the nephron, allowing glucose to be excreted in urine and reducing cardiac workload.
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