Finerenone

Finerenone is a  prescription medication used for the treatment of chronic kidney disease. 

• Finerenone is available under the following different brand names: Kerendia

Common side effects of Finerenone include:

• nausea,
• vomiting,
• diarrhea,
• confusion,
• irregular heartbeat,
• nervousness,
• numbness or tingling in the hands, feet, or lips,
• stomach pain,
• trouble breathing, and
• weakness or heaviness in the legs.

Serious side effects of Finerenone include:

• hives,
• difficulty breathing,
• swelling of the face, lips, tongue, or throat,
• severe dizziness,
• abdominal pain,
• diarrhea,
• chest pain,
• irregular or fast heartbeat,
• fluttering in the chest,
• muscle weakness,
• numbness in the limbs,
• nausea,
• vomiting, 
• headache,
• confusion,
• fatigue,
• restlessness,
• irritability,
• muscle spasms or cramps,
• seizures,
• coma,
• fainting,
• lack of concentration,
• blurred vision,
• cold, clammy, or pale skin,
• rapid, or shallow breathing, and
• depression

Rare side effects of Finerenone include:

• none 

This is not a complete list of side effects and other serious side effects or health problems that may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

Adult dosage

Tablet

• 10mg
• 20mg

Chronic Kidney Disease

Adult dosage

• Starting dose
  • Determine starting dose by eGFR (mL/min/1.73m2)
  • eGFR above 60: 20 mg orally every day
  • eGFR 25-60: 10 mg orally every day
  • eGFR less than 25: Not recommended
  • Increase dosage after 4 weeks to the target dose of 20 mg every day based on eGFR and serum potassium thresholds

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Finerenone has severe interactions with at least 26 other drugs.
• Finerenone has serious interactions with at least 35 other drugs.
• Finerenone has moderate interactions with at least 195 other drugs.
• Finerenone has minor interactions with no other drugs.

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all your products. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions or concerns.

Contraindications

• Concomitant treatment with strong CYP3A4 inhibitors
• Adrenal insufficiency

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Finerenone?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Finerenone?”

Cautions

Hyperkalemia

• Can cause hyperkalemia
• Risk increases with decreasing kidney function and is greater with higher baseline potassium levels or other risk factors for hyperkalemia
• Measure serum potassium and eGFR before initiating; adjust dose accordingly
• Do not initiate if serum potassium 5 mEq/L
• Periodically measure serum potassium during treatment and adjust the dose as necessary; more frequent monitoring is needed for patients at risk for hyperkalemia, including those on concomitant medications that impair potassium excretion or increase serum potassium

Drug interaction overview

• Finerenone is a CYP3A4 substrate
• Strong CYP3A4 inhibitors
  • Contraindicated
  • Avoid concomitant intake of grapefruit or grapefruit juice
  • Strong CYP3A4 inhibitors may increase the risk for finerenone adverse effects
• Moderate and weak CYP3A4 inhibitors
  • Monitor serum potassium during drug initiation or dosage adjustment of either finerenone or moderate/weak CYP3A4 inhibitor; adjust finerenone dose as appropriate
• Strong and moderate CYP3A4 inducers
  • Avoid coadministration
  • Strong and moderate CYP3A4 inducers decrease finerenone systemic exposure and may reduce the efficacy
• Drugs that affect serum potassium
  • More frequent serum potassium monitoring is warranted if coadministered with drugs or supplements that increase serum potassium or impair potassium excretion

Pregnancy & Lactation

• Data are not available on use in pregnancy to evaluate for a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes
• Animal studies have shown developmental toxicity at exposures ~4 times those expected in humans; the clinical significance of these findings is unclear

Lactation

• Data are unavailable on the presence of human milk, effects on breastfed infants, or effects on milk production
• Based on animal studies and the potential risk to breastfed infants from exposure, avoid breastfeeding during treatment and for 1 day after the last dose