Uses

Finerenone is a non-steroidal mineralocorticoid receptor antagonist indicated to reduce the risk of sustained eGFR decline, end-stage kidney disease, cardiovascular death, non-fatal myocardial infarction, and hospitalization for heart failure in adults with chronic kidney disease associated with type 2 diabetes. It is also indicated to reduce cardiovascular death and hospitalization for heart failure in adults with heart failure and left ventricular ejection fraction ≥ 40%.

Do not use if

Contraindicated in patients with known hypersensitivity to finerenone, patients receiving concomitant strong CYP3A4 inhibitors, and patients with adrenal insufficiency.

Side effects

The most clinically significant adverse reactions include hyperkalemia, hypotension, and hyponatremia. Hyperkalemia requiring dose adjustment or discontinuation is the most important safety concern.

Warnings

Monitor serum potassium levels before initiation and regularly during treatment; withhold or adjust dose based on potassium levels. Avoid concomitant use with strong or moderate CYP3A4 inhibitors. Monitor eGFR in heart failure patients for worsening renal function.

How it works

Finerenone is a selective non-steroidal antagonist of the mineralocorticoid receptor (MR), which is activated by aldosterone and cortisol. By blocking MR in both epithelial (kidney) and non-epithelial (heart, blood vessels) tissues, finerenone reduces sodium reabsorption and MR-mediated inflammation and fibrosis.

Storage

Store at controlled room temperature 20–25°C (68–77°F); excursions permitted between 15–30°C (59–86°F).