Non nifedipine can selectively and strongly affinity block the action of aldosterone on mineralocorticoid receptors (MR), thereby reducing blood pressure and alleviating cardiac burden.

1、 Drug name

1. Common name: Finerenone

2. Product Name: Kerendia

2、 Indications

It is used to reduce the risk of continuous decline of renal function, end-stage renal disease, cardiovascular death, non fatal myocardial infarction and hospitalization of heart failure in adult type 2 diabetes (T2D) related chronic kidney disease (CKD) patients.

3、 Specifications and characteristics

10mg film coated tablets

4、 Main components

Active ingredient: Non nalide ketone; The auxiliary materials include lactose, microcrystalline cellulose, etc. The film coating contains hydroxypropyl methylcellulose, iron oxide red (10mg) or iron oxide yellow (20mg).

5、 Usage and dosage

1. Initial dose: According to eGFR selection, for eGFR ≥ 60mL/min/1.73m ² patients, 20mg once daily; EGFR25-<60mL/min/1.73m ² 10mg once daily; EGFR<25mL/min/1.73m ² is not recommended for use.

2. Target dose: adjusted to 20mg once a day after 4 weeks (blood potassium and eGFR need to be monitored).

3. Usage: It can be taken with food or on an empty stomach. The whole tablet can be swallowed or crushed and mixed with water/soft food.

6、 Dose adjustment

1. Blood potassium ≤ 4.8mEq/L: can be increased from 10mg to 20mg.

2. Blood potassium>4.8-5.5mEq/L: maintain current dose; >Suspend administration at 5.5mEq/L, restart 10mg after blood potassium ≤ 5.0mEq/L.

3. Omission treatment: Supplement on the same day, otherwise skip the next day and take the medication according to the original plan.

7、 Medication precautions

1. Diet: Avoid grapefruit/grapefruit juice (which increases blood drug concentration).

2. Monitoring: Regularly check blood potassium and eGFR before and during medication.

3. Vomiting/absorption effects: Not clearly stated, it is recommended to consult a physician.

8、 Medication for special populations

1. Pregnant women: No human data available, animals show fetal toxicity, avoid use.

2. Breastfeeding period: Avoid breastfeeding within 1 day after discontinuing the medication.

3. Elderly: No need to adjust dosage.

4. Liver damage patients: severe liver damage (Child Pugh C) is contraindicated; Mild to moderate (A/B) does not require adjustment, but moderate requires enhanced blood potassium monitoring.

9、 Adverse reactions

Common (≥ 1% and higher than placebo): Hyperkalemia (14%), Hypotension (4.6%), Hyponatremia (1.3%).

10、 Contraindications

1. Combined use of potent CYP3A4 inhibitors (such as ketoconazole).

2. Patients with adrenal insufficiency.

11、 Drug interactions

1. CYP3A4 inhibitors: Strong (contraindicated), moderate to weak (blood potassium needs to be monitored).

2. CYP3A4 inducer: Strong moderate effect (avoid combination use).

3. Potassium boosting drugs, such as potassium supplements and potassium sparing diuretics, require close monitoring of blood potassium levels.

12、 Storage method

Store at room temperature of 20-25 ℃, allowing short-term fluctuations of 15-30 ℃.

finerenoneinformation