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Finerenone is used to lower the risk of:
- Sustained decline in eGFR
- End-stage kidney disease
- Cardiovascular death
- Nonfatal heart attack
- Hospitalization for heart failure
➡️ For adult patients with chronic kidney disease (CKD) linked to type 2 diabetes (T2D)
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✅ Description:
- Finerenone is a non-steroidal, selective mineralocorticoid receptor (MR) antagonist.
- It blocks aldosterone and cortisol-induced MR overactivation, which reduces inflammation and fibrosis in kidney, heart, and blood vessels.
- It has high affinity for MR, but minimal interaction with other hormone receptors.
- It causes slight reductions in blood pressure (systolic: ↓3 mmHg, diastolic: ↓1–2 mmHg).
- Rapid absorption: Cmax within 0.5–1.25 hours, bioavailability ≈ 44%.
- Finerenone is mainly metabolized by CYP3A4, with some contribution from CYP2C8.
Relevant Products / প্রাসঙ্গিক পণ্য
✔️ Most common adverse reactions:
Hyperkalemia
Low blood pressure (hypotension)
Low sodium (hyponatremia)
✔️ Dosage & Administration
Start Dose (based on eGFR):
| eGFR | Recommended Starting Dose |
|---|---|
| ≥60 mL/min/1.73 m² | 20 mg once daily |
| 25–59 mL/min/1.73 m² | 10 mg once daily |
| <25 mL/min/1.73 m² | Not recommended |
Maintenance dose: 20 mg once daily
Take with or without food
Crushable for mixing with water or soft foods
Children: Safety not established in <18 years
Elderly (≥65 years): Safe without dose adjustment
Liver impairment:
Mild to moderate (Child-Pugh A/B): No adjustment needed; monitor potassium
Severe (Child-Pugh C): Avoid use
Missed dose: Take same day only; skip if remembered next day
- Check serum potassium and eGFR before starting
- Do not start if serum potassium > 5.0 mEq/L
- Monitor potassium 4 weeks after starting or adjusting dose
- Adjust dose as necessary to avoid hyperkalemia
✔️ Drug Interactions
Avoid with:
Strong CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin, grapefruit)
CYP3A4 inducers (e.g., rifampin, carbamazepine) — may reduce efficacy
Caution with:
Moderate/weak CYP3A4 inhibitors – Monitor potassium levels closely
✔️ Warnings & Precautions
Hyperkalemia risk increases in patients with impaired kidney function or elevated baseline potassium
Frequent monitoring is recommended for high-risk patients or those on drugs affecting potassium levels
Do not breastfeed during treatment or for 1 day after the last dose
✔️ Pregnancy & Lactation
Pregnancy Category: No human data; animal studies show possible fetal harm
Breastfeeding: Likely excreted in milk – avoid during use and for 1 day after final dose
✔️ Storage:
Store below 30°C
Protect from light and moisture
Keep out of children’s reach
⚠️Disclaimer:
At ePharma, we’re committed to providing accurate and accessible health information. However, all content is intended for informational purposes only and should not replace medical advice from a qualified physician. Please consult your healthcare provider for personalized guidance. We aim to support, not substitute, the doctor-patient relationship.
