Generic Medicine Info
Indications and Dosage
Chronic kidney disease associated with type 2 diabetes mellitus
Adult: To reduce the risk of sustained eGFR decline, ESRD, CV death, non-fatal MI, and hospitalisation for heart failure in cases with albuminuria, in addition to standard of care: Recommended target dose: 20 mg once daily. eGFR 25-59 mL/min/1.73 m2: Initially, 10 mg once daily; may increase after 4 weeks to 20 mg once daily based on eGFR and serum K thresholds. eGFR ≥60 mL/min/1.73 m2: Initially, 20 mg once daily. Do not initiate treatment if eGFR is <25 mL/min/1.73 m2 or serum K is >5 mmol/L. Dose adjustment or interruption may be required according to eGFR and serum K thresholds (refer to detailed product guidelines).
Hepatic Impairment
Severe (Child-Pugh class C): Avoid use.
May be taken with or without food. Swallow whole. For patients w/ swallowing difficulties, tab may be crushed and mixed w/ water or soft foods (e.g. applesauce). Take immediately.
Adrenal insufficiency. Concomitant use with strong CYP3A4 inhibitors.
Special Precautions
Patient with risk factors for hyperkalaemia (e.g. low eGFR, higher baseline K levels, previous episodes of hyperkalaemia). Moderate hepatic impairment (Child-Pugh class B); avoid use in severe hepatic impairment (Child-Pugh class C). Pregnancy and lactation.
Adverse Reactions
Significant: Hyperkalaemia.
Investigations: Decreased GFR.
Metabolism and nutrition disorders: Hyponatraemia.
Skin and subcutaneous tissue disorders: Pruritus.
Vascular disorders: Hypotension.
Monitoring Parameters
Measure serum K (at baseline, 4 weeks after initiation of therapy or dosage adjustments, and periodically during therapy), eGFR (at baseline and periodically during therapy), and LFT.
Drug Interactions
Moderate CYP3A4 inhibitors (e.g. erythromycin, verapamil) or weak CYP3A4 inhibitors (e.g. amiodarone, fluvoxamine) may increase finerenone exposure. Increased risk of hyperkalaemia with drugs that increase serum K including K supplements, K-sparing diuretics (e.g. amiloride, triamterene), other mineralocorticoid receptor antagonists (e.g. eplerenone, esaxerenone, spironolactone, canrenone), trimethoprim or trimethoprim + sulfamethoxazole. Strong CYP3A4 inducers (e.g. carbamazepine, phenytoin, phenobarbital, rifampicin) or moderate CYP3A4 inducers (e.g. efavirenz) may decrease the plasma concentration of finerenone.
Potentially Fatal: Strong CYP3A4 inhibitors (e.g. ketoconazole, itraconazole, cobicistat, clarithromycin, telithromycin, ritonavir, nelfinavir, nefazodone) significantly increase finerenone exposure, which may increase the risk of adverse reactions.
Food Interaction
Concomitant intake of grapefruit or grapefruit juice significantly increases the plasma concentration of finerenone; avoid concomitant intake. May reduce plasma concentration with St. John's wort.
Description: Finerenone is a nonsteroidal, selective antagonist of the mineralocorticoid receptor (MR), which is activated by cortisol and aldosterone and regulates gene transcription. It blocks MR-mediated Na reabsorption and decreases MR overactivation in both epithelial (e.g. kidney) and nonepithelial (e.g. blood vessels, heart) tissues, thereby reducing inflammation and fibrosis.
Absorption: Almost completely absorbed. Bioavailability: 44%. Time to peak plasma concentration: 0.5-1.25 hours.
Distribution: Plasma protein binding: 92%, mainly to albumin.
Metabolism: Metabolised in the liver mainly by CYP3A4 (90%) and to a lesser extent by CYP2C8 (10%) into 4 major inactive metabolites.
Excretion: Mainly via urine (approx 80%; <1% as unchanged drug); faeces (approx 20%; <0.2% as unchanged drug). Elimination half-life: Approx 2-3 hours.
Chemical Structure

Chemical Structure Image

Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 60150535, Finerenone. Accessed Feb. 27, 2023.

Store below 30°C.
MIMS Class
Other Drugs Acting on the Genito-Urinary System
ATC Classification
C03DA05 - finerenone ; Belongs to the class of aldosterone antagonists. Used as potassium-sparing diuretics.
Anon. Finerenone. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. Accessed 04/01/2023.

Anon. Finerenone. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. Accessed 04/01/2023.

Buckingham R (ed). Finerenone. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. Accessed 04/01/2023.

Joint Formulary Committee. Finerenone. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. Accessed 04/01/2023.

Kerendia 20 mg Film Coated Tablets (Bayer plc). MHRA. Accessed 04/01/2023.

Kerendia Tablet, Film Coated (Bayer Healthcare Pharmaceuticals Inc.). DailyMed. Source: U.S. National Library of Medicine. Accessed 04/01/2023.

Kerendia Tablets (Bayer HealthCare Limited [HK]). MIMS Hong Kong. Accessed 16/02/2023.

Disclaimer: This information is independently developed by MIMS based on Finerenone from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2023 MIMS. All rights reserved. Powered by
Register or sign in to continue
Asia's one-stop resource for medical news, clinical reference and education
Already a member? Sign in
Register or sign in to continue
Asia's one-stop resource for medical news, clinical reference and education
Already a member? Sign in