Finerenone

Pronunciation: fin-ER-en-one.

Generic name: finerenone
Drug class: Non-steroidal mineralocorticoid receptor antagonist (nsMRA)
Form: Film-coated tablet, 10 mg and 20 mg
Route: Oral
Legal status: Prescription-only

Availability and supply rules vary by country

Trade names by country: United States · United Kingdom · Canada · Australia

Australia: Kerendia (5) · Full directory

What finerenone is and how it works

Finerenone is a prescription-only medicine that blocks a receptor (the mineralocorticoid receptor) involved in kidney and heart damage from excess inflammation and scarring. It is used to slow the progression of chronic kidney disease in people with type 2 diabetes, and separately to reduce cardiovascular events in certain types of heart failure. (1)

Take finerenone exactly as your prescriber directs, once daily. Your starting dose and any changes depend on your kidney function (eGFR) and blood potassium level, which your prescriber will check before and during treatment.

Mechanism of action: how finerenone works

Finerenone is a non-steroidal, selective antagonist of the mineralocorticoid receptor, reducing receptor-mediated inflammation and fibrosis in the kidney and heart without the steroid-hormone-like side effects associated with older steroidal mineralocorticoid receptor antagonists. Absolute oral bioavailability is approximately 43.5%, reflecting first-pass gut-wall and hepatic metabolism, and it is metabolised predominantly via CYP3A4. (1) (4)

What finerenone is used for

Chronic kidney disease associated with type 2 diabetes

Used in adults with chronic kidney disease linked to type 2 diabetes, to reduce the risk of the kidney disease getting worse, kidney failure, cardiovascular death, heart attack, and hospitalisation for heart failure. (1) (5)

Heart failure with mildly reduced or preserved ejection fraction (LVEF 40% or higher)

Used in adults with this type of chronic heart failure to reduce cardiovascular death, hospitalisation for heart failure, and urgent heart failure visits. (1) (2)

Before taking finerenone

Do not take / not appropriate for

Do not take finerenone if you have Addison's disease (adrenal insufficiency). (all countries) (1) (2) (3)
Do not take finerenone together with certain strong medicines that block an enzyme called CYP3A4 (for example some antifungal or antibiotic medicines, or certain HIV medicines) -- tell your prescriber about all medicines you take so they can check for this. (all countries) (1) (2)
Do not start finerenone if a blood test shows your potassium level is already high. (all countries) (1) (2)

Tell your clinician about

Any history of high blood potassium (hyperkalaemia).
Any liver problems, especially severe liver disease.
All other medicines you take, including potassium supplements, potassium-sparing water tablets, or other medicines that affect potassium or CYP3A4.
Pregnancy, plans for pregnancy, or breastfeeding.

(1) (2)

How to take finerenone

Take by mouth once daily, with or without food, at around the same time each day.
Swallow the tablet whole, or it can be crushed and mixed with water or soft food immediately before use if needed.
Grapefruit and grapefruit juice should be avoided, as they can increase levels of the medicine in the body.
Continue routine blood tests for potassium and kidney function as scheduled by your prescriber -- these guide whether your dose stays the same, is adjusted, or is paused.

(1)

Procedures and treatment changes

Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1) (2) (3) (4) (5)

Missed dose

Take the missed dose as soon as you remember on the same day. Do not take a double dose to make up for a missed one. Contact your prescriber if you are unsure.

Overdose

Seek urgent medical attention if you think you have taken too much finerenone, particularly if you develop symptoms of high blood potassium such as muscle weakness or an irregular heartbeat, or if blood pressure drops significantly. (1)

Side effects

Side effects and their urgency vary; report severe, persistent, or concerning symptoms.

High blood potassium (hyperkalaemia) -- the most common side effect.

What to notice: High blood potassium (hyperkalaemia) -- the most common side effect.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1) (2)

Low blood pressure (hypotension), which may cause dizziness.

What to notice: Low blood pressure (hypotension), which may cause dizziness.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1) (2)

Low blood sodium (hyponatraemia).

What to notice: Low blood sodium (hyponatraemia).

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)

Raised uric acid levels.

What to notice: Raised uric acid levels.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (2) (3)

A temporary drop in kidney function (eGFR) shortly after starting or increasing the dose.

What to notice: A temporary drop in kidney function (eGFR) shortly after starting or increasing the dose.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (2) (3)

Digestive symptoms such as diarrhoea or constipation.

What to notice: Digestive symptoms such as diarrhoea or constipation.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (2)

Serious warnings

Signs of high blood potassium (hyperkalaemia) — high caution

Symptoms: Often no symptoms at all -- this is usually picked up on a routine blood test. If severe, it can cause muscle weakness, tingling, or an irregular heartbeat.

Action: Keep all scheduled blood tests for potassium and kidney function. Contact your prescriber promptly if you are told your potassium is high or if you notice unusual muscle weakness or heart palpitations -- your prescriber will decide whether to adjust or pause your dose. (1) (2)

Signs of a serious allergic reaction — emergency

Symptoms: Swelling of the face, lips, tongue, or throat; difficulty breathing; widespread rash or hives.

Action: Seek emergency medical help immediately. (2)

Signs of worsening kidney function — high caution

Symptoms: Usually detected through routine blood tests rather than obvious symptoms; occasionally reduced urine output or swelling.

Action: Attend all scheduled kidney-function monitoring. Contact your prescriber if you notice a marked change in urination or new swelling -- they will assess whether treatment needs adjusting. (2) (3)

Interactions

Strong CYP3A4-inhibiting medicines (such as certain antifungals, some antibiotics, and some HIV medicines) are not to be combined with finerenone -- this combination is contraindicated. (1) (2)
Moderate or weak CYP3A4-inhibiting medicines (such as erythromycin, verapamil, or fluvoxamine) can raise finerenone levels -- your prescriber may want closer potassium monitoring if these are combined. (2)
Strong or moderate CYP3A4-inducing medicines (such as rifampicin, carbamazepine, or phenytoin) can reduce how well finerenone works and are generally avoided. (2)
Potassium supplements, potassium-sparing diuretics, other mineralocorticoid receptor antagonists, and co-trimoxazole (trimethoprim/sulfamethoxazole) can further raise blood potassium when combined with finerenone. (2)
Grapefruit and grapefruit juice can increase finerenone levels in the body and should be avoided. (1) (2)

Pregnancy, breastfeeding, kidney/liver function, age

Pregnancy

Finerenone should not be used in pregnancy unless a prescriber decides your clinical condition specifically requires it, since animal studies showed developmental toxicity. Discuss with your prescriber if you are or could become pregnant. (1) (2) (3) (4) (5)

Breastfeeding

It is not known whether finerenone passes into human breast milk, and a risk to a breastfed infant cannot be excluded. Discuss with your prescriber whether to breastfeed or take this medicine. (1) (2) (3) (4) (5)

Children

Not established as safe and effective in children; approved only for adults in the sources reviewed. (1) (2) (3) (4) (5)

Elderly

No dose adjustment is needed based on age alone; a large proportion of people in clinical trials were 65 years or older. (1) (2) (3) (4) (5)

Hepatic_impairment

Avoid use in severe liver impairment (Child-Pugh C). In moderate liver impairment, potassium is monitored more closely, since finerenone levels can rise. (1) (2) (3) (4) (5)

Renal_impairment

Dosing depends directly on kidney function (eGFR); not recommended for starting treatment if eGFR is below 25 mL/min/1.73m^2 in the sources reviewed. Kidney function is monitored closely throughout treatment. (1) (2) (3) (4) (5)

Source_ids

US-DAILYMED-KERENDIA-2026,UK-EMC-KERENDIA-2026 (1) (2) (3) (4) (5)

Monitoring

Before starting

Serum potassium
eGFR (kidney function)
Review of other medicines affecting potassium or CYP3A4

During treatment

Serum potassium and eGFR re-checked around 4 weeks after starting or restarting, and after any dose increase.
Periodic potassium and kidney function monitoring thereafter, as directed by your prescriber.
Closer potassium monitoring if combined with certain other medicines or in moderate liver impairment.

(1) (2)

Storage

Store at 20-25 degrees C (68-77 degrees F); brief excursions between 15-30 degrees C are permitted. Keep in the original packaging.

Study the drug class: Mineralocorticoid receptor antagonists

Professional information

Clinician-facing context only, sourced from the current US FDA prescribing information and UK/EU SmPC; verify against the current full label before prescribing.

United States / United Kingdom / European Union

Indication: CKD associated with T2DM; heart failure with LVEF >=40%

Dose summary: Starting dose 10 mg or 20 mg once daily based on baseline eGFR and serum potassium; target dose up to 20 mg (CKD+T2D) once daily, titrated at approximately 4 weeks based on repeat potassium/eGFR. Not recommended to initiate if potassium >5.0 mEq/L (mmol/L); the prescriber will withhold treatment, per label-specific thresholds, if potassium rises above 5.5-6.0 mmol/L depending on indication.

Renal context: Starting dose and eligibility to initiate are directly tied to eGFR band; not recommended for initiation at very low eGFR (below approximately 25 mL/min/1.73m^2) per the sources reviewed. (1) (2)

Mechanism of action

Hepatic guidance

Avoid in severe hepatic impairment (Child-Pugh C); monitor potassium more closely in moderate hepatic impairment given increased exposure.

Overdose note

No specific antidote; manage hyperkalaemia and hypotension supportively with standard measures and monitoring if overdose is suspected. (1) (4)

Frequently asked questions

Is finerenone (Kerendia) available in the US, UK, Europe, Canada, and Australia?

Yes, it is approved and available in all of these regions. New Zealand availability could not be confirmed with a specific data sheet at the time of this review, despite a prescription-medicine classification existing there. (1) (3) (2) (4) (5)

Why do I need regular blood tests while taking finerenone?

Finerenone can raise blood potassium and can temporarily reduce kidney function, especially soon after starting or increasing the dose. Regular blood tests let your prescriber catch this early and adjust your treatment if needed. (1) (2)

Can I eat grapefruit while taking finerenone?

No. Grapefruit and grapefruit juice can raise finerenone levels in a similar way to strong drug interactions, so they should be avoided. Finerenone is also contraindicated with strong CYP3A4-inhibiting medicines such as itraconazole, ritonavir, and clarithromycin, so tell your clinician and pharmacist about every medicine you take. (1)

What is the mechanism of action of finerenone?

What is the generic name of Finerenone?

The generic name is finerenone. (1)

What class of drug is finerenone?

Finerenone is classed as: Non-steroidal mineralocorticoid receptor antagonist (nsMRA). (1)

References

KERENDIA (finerenone) tablets -- full prescribing informationU.S. Food and Drug Administration / DailyMed (NIH), full prescribing information, Bayer HealthCare Pharmaceuticals Inc. · United States · accessed 2026-07-29 · source 1
Kerendia 20 mg film-coated tablets -- Summary of Product Characteristicselectronic medicines compendium (emc), United Kingdom -- Bayer · United Kingdom · accessed 2026-07-29 · source 2
Kerendia (finerenone) -- European Public Assessment Report (EPAR) overviewEuropean Medicines Agency (EMA) · European Union · accessed 2026-07-29 · source 3
KERENDIA (finerenone) Product MonographHealth Canada product monograph · Canada · accessed 2026-07-29 · source 4
KERENDIA finerenone 10 mg / 20 mg film-coated tablets -- ARTG registrationTherapeutic Goods Administration (TGA), Australia · Australia · accessed 2026-07-29 · source 5
Finerenone -- prescription medicine classification (NZ Gazette notices, most recent 2024-10-07)Medsafe (New Zealand regulator) -- classification gazette notices · New Zealand · accessed 2026-07-29 · source 6

Brand names by country

Single-ingredient finerenone names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.

Priority countries

United States

Kerendia20 mg, 40 mg, 10 mg · bayer healthcare pharmaceuticals inc.

United Kingdom

Kerendia (2)MHRA licensed emc smpc confirmed · 10 mg, 20 mg · Bayer

Canada

Kerendia (4)Health Canada NOC 2022-10-14 confirmed · 10 mg, 20 mg · Bayer Inc.

Australia

Kerendia (5)TGA ARTG registered 2021-11-25 confirmed · 10 mg, 20 mg · Bayer Australia Ltd

View brands in additional countries.

European Union

Kerendia (3)