Finelinone is a selective nonsteroidal mineralocorticoid receptor antagonist, which is mainly used to treat type 2 diabetes related chronic kidney disease, reduce the risk of cardiovascular events and delay the progression of kidney disease. The standard dose is once daily oral administration, which needs to be adjusted according to renal function and monitored for blood potassium levels.

1 Standard Dose Protocol

(1) Adult chronic kidney disease with type 2 diabetes: the recommended starting dose is 10mg or 20mg, taken orally once a day, which is determined according to the estimated glomerular filtration rate (eGFR).

(2) Medication time: Take at a fixed time every day, with or without food, to maintain consistency in administration.

Principle of dose adjustment

(1) EGFR ≥ 60mL/min/1.73m ²: initial dose 20mg/day, maintenance dose 20mg/day.

(2) EGFR25-59mL/min/1.73m ²: initial dose 10mg/day, maintenance dose 10mg/day.

(3) EGFR<25mL/min/1.73m ²: Not recommended for use.

3. Medication for special populations

(1) Liver dysfunction: Mild to moderate injury does not require adjustment, severe injury (Child Pugh C grade) should be used with caution.

(2) Elderly: No need to adjust dosage, but close monitoring of kidney function and blood potassium is required.

4 Monitoring requirements

(1) Blood potassium monitoring: Blood potassium levels should be measured before treatment, at 4 weeks, 12 weeks, and after dose adjustment.

(2) Renal function monitoring: Regularly evaluate eGFR during treatment, especially for patients with renal insufficiency.

5 Precautions for Combination Medication

(1) Strong CYP3A4 inhibitor: Avoid combination therapy and reduce dosage to 10mg/day when necessary.

(2) CYP3A4 inducer: may reduce the efficacy of non nifedipine and alternative therapies need to be considered.