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Kerendia
finerenone
Adult Dosing .
Dosage forms: TAB: 10 mg, 20 mg
kidney dz progression and cardiovascular-associated risk reduction - DM type 2 pts w/ CKD
- [20 mg PO qd]
- Info: use for risk reduction of sustained eGFR decline, ESRD, cardiovascular death, non-fatal MI, and heart failure hospitalization; see pkg insert for dose adjustments based on potassium levels
renal dosing
- [see below]
- eGFR 25-59: start 10 mg qd, may incr. to 20 mg qd after 4wk based on potassium level and eGFR; eGFR <25: avoid tx initiation; Info: see pkg insert for dose adjustments based on potassium levels and eGFR
- HD/PD: not defined
hepatic dosing
- [see below]
- Child-Pugh Class C: avoid use
Peds Dosing .
Peds dosing is currently unavailable or not applicable for this drug.
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- K >5
- eGFR <25 (tx initiation use)
- adrenal insufficiency
- avoid: breastfeeding during tx and x1 day after D/C
- caution: eGFR 25-59
- caution: hepatic impairment
- caution: hyperkalemia risk
Drug Interactions .
Overview
finerenone
mineralocorticoid antagonist
- CYP3A4 substrate
- hyperkalemia
Contraindicated
- adagrasib
- atazanavir
- ceritinib
- chloramphenicol
- clarithromycin
- cobicistat
- idelalisib
- itraconazole
- ketoconazole
- levoketoconazole
- lonafarnib
- lopinavir/ritonavir
- mifepristone
- nefazodone
- nelfinavir
- posaconazole
- ribociclib
- ritonavir
- tipranavir
- tucatinib
- voriconazole
Avoid/Use Alternative
- amiloride
- apalutamide
- bosentan
- butalbital
- carbamazepine
- cenobamate
- dabrafenib
- efavirenz
- encorafenib
- enzalutamide
- etravirine
- fexinidazole
- fosphenytoin
- ivosidenib
- lorlatinib
- lumacaftor/ivacaftor
- mavacamten
- mitapivat
- mitotane
- modafinil
- nafcillin
- netupitant
- pacritinib
- pentobarbital
- pexidartinib
- phenobarbital
- phenytoin
- potassium chloride
- primidone
- repotrectinib
- rifabutin
- rifampin
- rifapentine
- sotorasib
- St. John's wort
- tacrolimus
Monitor/Modify Tx
- aliskiren
- alprazolam
- amiodarone
- amlodipine
- aprepitant
- asciminib
- atorvastatin
- avacopan
- belumosudil
- benazepril
- berberine
- berotralstat
- bicalutamide
- candesartan cilexetil
- capivasertib
- captopril
- celecoxib
- chlorzoxazone
- cilostazol
- cimetidine
- ciprofloxacin
- clofazimine
- clotrimazole oropharyngeal
- conivaptan
- cranberry
- crizotinib
- cyclosporine
- danazol
- daridorexant
- darunavir
- decitabine
- diclofenac
- diclofenac topical
- diflunisal
- diltiazem
- diosmin
- dronedarone
- drospirenone (contraceptive)
- drospirenone (hormone replacement)
- duvelisib
- enalapril
- enalaprilat
- entrectinib
- eplerenone
- erythromycin
- ethinyl estradiol (contraceptive)
- etodolac
- everolimus
- fedratinib
- fenoprofen
- flibanserin
- fluconazole
- flurbiprofen
- fluvoxamine
- fosamprenavir
- fosaprepitant
- fosinopril
- fostamatinib
- gepotidacin
- ginkgo
- givinostat
- givosiran
- glecaprevir
- goldenseal
- grapefruit
- grazoprevir
- heparin
- ibuprofen
- imatinib
- indomethacin
- irbesartan
- isavuconazonium
- isoniazid
- istradefylline
- ivacaftor
- ketoprofen
- ketorolac
- kratom
- landiolol
- lapatinib
- larotrectinib
- lazertinib
- lefamulin
- lenacapavir
- letermovir
- lisinopril
- lomitapide
- losartan
- lovastatin
- lurasidone
- maribavir
- mavorixafor
- meclofenamate
- mefenamic acid
- meloxicam
- moexipril
- nabumetone
- naproxen
- nicardipine
- nilotinib
- nirogacestat
- olmesartan medoxomil
- osilodrostat
- oxaprozin
- palbociclib
- pazopanib
- peppermint
- perindopril
- pibrentasvir
- piroxicam
- pirtobrutinib
- potassium acid phosphate
- potassium bicarbonate
- potassium citrate
- potassium iodide
- potassium phosphate
- quercetin
- quinapril
- ramipril
- ranolazine
- remdesivir
- resveratrol
- ritlecitinib
- rucaparib
- selpercatinib
- sparsentan
- spironolactone
- stiripentol
- sulindac
- telmisartan
- ticagrelor
- tolmetin
- tolvaptan
- trandolapril
- treosulfan
- triamterene
- trimethoprim
- trofinetide
- valsartan
- verapamil
- viloxazine
- voclosporin
- vonoprazan
- voxelotor
- xanomeline
- zileuton
Caution Advised
- armodafinil
- artemether/lumefantrine
- belzutifan
- bexarotene
- brigatinib
- clobazam
- danshen
- darolutamide
- dexamethasone
- dicloxacillin
- echinacea
- elafibranor
- elagolix
- enasidenib
- eslicarbazepine acetate
- felbamate
- garlic
- ginseng, Asian
- glycerol phenylbutyrate
- griseofulvin
- meropenem
- mobocertinib
- nevirapine
- odevixibat
- olutasidenib
- omaveloxolone
- oxcarbazepine
- perampanel
- pioglitazone
- prednisone
- rufinamide
- sarilumab
- somatropin
- suzetrigine
- tazemetostat
- tecovirimat
- tocilizumab
- topiramate
- tovorafenib
- vaborbactam
- vamorolone
- vemurafenib
- vinblastine
- vorasidenib
- zanubrutinib
Adverse Reactions .
Serious Reactions
- hyperkalemia, severe
Common Reactions
- hyperkalemia
- hypotension
- hyponatremia
- eGFR decr.
Safety/Monitoring .
Monitoring Parameters
eGFR at baseline, then as clinically indicated; K at baseline, then 4wk after tx start or dose adjustment (or more frequently if baseline K 4.8-5), then periodically, or consider more frequently if Child-Pugh Class B hepatic impairment or hyperkalemia risk
Pregnancy/Lactation .
Pregnancy
Clinical Summary
weigh risk/benefit during pregnancy; no human data available; possible risk of developmental toxicity based on animal data at 4x systemic exposure
Lactation
Clinical Summary
avoid breastfeeding during tx and x1 day after D/C; no human data available to assess risk of infant harm, though possible drug excretion into milk based on drug properties; no human data available to assess effects on milk production
Pharmacology .
Metabolism: liver; CYP450: 2C8, 3A4 (primary) substrate
Excretion: urine 80% (<1% unchanged), feces 20% (<0.2% unchanged); Half-life: 2-3h
Subclass: Mineralocorticoid Receptor Antagonists, Nonsteroidal
Mechanism of Action
selectively antagonizes mineralocorticoid receptors, inhibiting Na reabsorption and mineralocorticoid receptor overactivation in epithelial and nonepithelial tissues
Formulary .
No Formulary Selected
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