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How does this medication work? What will it do for me?

Finerenone belongs to the class of medications called aldosterone antagonists. It is added to standard treatments for kidney disease and type 2 diabetes to reduce the risk of end-stage kidney disease, non-fatal heart attack, hospitalization for heart failure and death caused by heart disease in adults who have type 2 diabetes and long-term kidney disease.

Over time, type 2 diabetes can cause damage to the kidneys, reducing their ability to remove waste and fluid from the body. Decreased kidney function then leads to increased blood pressure and increased risk of heart disease.

Finerenone works by blocking aldosterone, a substance the body makes that helps control blood pressure. High levels of aldosterone increase blood pressure and may contribute to heart failure. Blocking aldosterone helps prevent heart failure from worsening.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

How should I use this medication?

The recommended starting dose of finerenone is 10 mg to 20 mg taken by mouth, once daily, depending on the amount of potassium in the blood and kidney function. Your doctor may adjust your dose to a maximum of 20 mg daily after 4 weeks. This medication should be taken at approximately the same time every day, and may be taken with or without food. Swallow the tablet whole with a glass of water.

If you are unable to swallow the tablet whole, it may be crushed and mixed with water or a soft food such as applesauce immediately before taking it.

Grapefruit and grapefruit juice should be avoided while taking finerenone.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

What form(s) does this medication come in?

10 mg
Each pink, film-coated, oval oblong tablet marked with "10" on one side and "FI" on the other side, contains 10 mg of finerenone. Nonmedicinal ingredients: cellulose microcrystalline, croscarmellose sodium, ferric oxide red, hypromellose 5cP, lactose monohydrate, magnesium stearate, sodium lauril sulfate, talc, and titanium dioxide.

20 mg
Each pale yellow, film-coated, oval oblong tablet marked with "20" on one side and "FI" on the other side, contains 20 mg of finerenone. Nonmedicinal ingredients: cellulose microcrystalline, croscarmellose sodium, ferric oxide yellow, hypromellose 5cP, lactose monohydrate, magnesium stearate, sodium lauril sulfate, talc, and titanium dioxide.

Who should NOT take this medication?

Do not take this medication if you:

  • are allergic to finerenone or any ingredients of the medication
  • are taking certain other medications, including, but not limited to:
    • antifungal medications, such as itraconazole and ketoconazole
    • clarithromycin
    • cobicistat
    • ritonavir
  • have Addison's disease
What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • itchy skin

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • symptoms of anemia (decreased red blood cells; e.g., paleness, weakness, tiredness, loss of energy, lightheadedness, shortness of breath, unusually fast heartbeat, chest pain)
  • symptoms of decreased sodium in the blood (e.g., nausea, tiredness, headache, confusion, muscle weakness, muscle spasms or cramps)
  • symptoms of decreased kidney function (e.g., increased frequency of urinating, fatigue, muscle cramps, vomiting, loss of appetite)
  • symptoms of increased potassium in the blood (e.g., weakness, tiredness, nausea, numbness in hands and lips, muscle cramps, decreased heart rate)
  • symptoms of increased uric acid in the blood (e.g., pain, joint stiffness, swelling, heat or redness)
  • symptoms of low blood pressure (e.g., blurred vision, fatigue, dizziness rising from a sitting or lying position, nausea)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Galactose intolerance/glucose malabsorption:  Finerenone tablets are prepared with lactose. If you have lactose or galactose intolerance you should not take this medication.

Grapefruit juice: Grapefruit or grapefruit juice affects how finerenone is removed from the body and may cause too much of the medication to build up in the body and cause possibly harmful side effects. Avoid consuming grapefruit or grapefruit juice while taking this medication.

Liver function: Liver disease or reduced liver function may cause this medication to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. People with severely decreased liver function should not take finerenone.

Potassium levels: Increases in blood levels of potassium can occur for a small percentage of people taking finerenone. This rarely causes problems, but potassium levels should be monitored by your doctor. If you experience unexplained nausea, fatigue, muscle weakness or tingling sensations, contact your doctor.

Pregnancy: This medication may cause harm to the developing baby if it is taken by the mother while pregnant. Finerenone should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if finerenone passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children.

Seniors: Seniors may be at an increased risk of experiencing side effects of finerenone.

What other drugs could interact with this medication?

There may be an interaction between finerenone and any of the following:

  • alprazolam
  • amiodarone
  • angiotensin-converting enzyme inhibitors (ACEIs; e.g., captopril, cilazapril, enalapril, fosinopril, lisinopril, perindopril, ramipril)
  • angiotensin receptor blockers (ARBs; e.g., azilsartsan, candesartan, eprosartan, irbesartan, losartan)
  • apalutamide
  • aprepitant
  • "azole" antifungals (e.g., fluconazole, ketoconazole, itraconazole, posaconazole, voriconazole)
  • bicalutamide
  • bosentan
  • calcium channel blockers (e.g., amlodipine, diltiazem, verapamil)
  • certain protein kinase inhibitors (e.g., ceritinib, crizotinib, dabrafenib, idelalasib, imatinib, lapatinib, nilotinib, pazopanib, ribociclib)
  • cimetidine
  • ciprofloxacin
  • cobicistat
  • conivaptan
  • cyclosporine
  • danazol
  • dronedarone
  • efavirenz
  • elagolix
  • etravirine
  • enzalutamide
  • everolimus
  • fludrocortisone
  • fluvoxamine
  • grapefruit juice
  • hepatitis C antivirals (e.g., elbasvir and grazoprevir, glecaprevir, pibrentasvir)
  • HIV protease inhibitors (e.g., atazanavir, darunavir, ritonavir)
  • isoniazid
  • letermovir
  • lomitapide
  • lumacaftor and ivacaftor
  • macrolide antibiotics (e.g., clarithromycin, erythromycin)
  • mifepristone
  • modafinil
  • other aldosterone antagonists (e.g., eplerenone, spironolactone)
  • potassium supplements
  • potassium-sparing diuretics (water pills; e.g., amiloride, triamterene)
  • propiverine
  • ranolazine
  • rifabutin
  • rifampin
  • St. John's wort
  • seizure medications (e.g., carbamazepine, eslicarbazepine, phenobarbital, phenytoin)
  • treosulfan

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over the counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.s

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