Generic name: finerenone
Dosage form: tablets
Drug class: Aldosterone receptor antagonists

Medically reviewed by Melisa Puckey, BPharm. Last updated on July 14, 2025.

What is Kerendia?

Kerendia (finerenone) is an FDA-approved tablet taken once a day by adults who have heart failure or chronic kidney disease (from type 2 diabetes).  Kerendia is used to slow down kidney damage, and also to reduce the risk of kidney failure, cardiovascular death, heart attack, and being hospitalized for heart failure.

Kerendia is from the class of medicines called mineralocorticoid receptor antagonists.

Chronic kidney disease (CKD) is when your kidneys are not working properly and they work less effectively over time. Having type 2 diabetes increases your chances of having chronic kidney disease. Often, type 2 diabetics do not have any symptoms in the early stages of CKD, and they might not realize they have it until it is advanced, and they may need to have dialysis or a kidney transplant to survive. If you have diabetes, it is important to get your kidneys checked regularly by having a blood and urine test. If you have signs of reduced kidney function or the start of CKD, early treatment can help prevent you from having extra health problems. 

When you have CKD, you have health problems from fluid, electrolytes (minerals required for many bodily processes), and waste building up in the body. If you have CKD, you are also at high risk of heart disease.

How does Kerendia work, and what is its mechanism of action?

One of the reasons CKD can get worse in diabetes is due to inflammation and scarring of the kidneys.  

How Kerendia is thought to work is:

• There is a receptor in the kidneys, heart, and blood vessel tissues that is called the mineralocorticoid receptor (MR). 
• When MR is overactive, it leads to inflammation, tissue damage, and scarring, which is thought to cause kidney disease and cardiovascular disease to become worse.
• Kerendia blocks the MR so that it is not as active, so the MR is less likely to cause as much inflammation and damage to the kidneys, blood vessels, and heart.
• This means Kerendia slows CKD from getting worse and also lowers the risk of cardiovascular death, having a heart attack, or needing to be hospitalized for heart failure.

Kerendia's mechanism of action is as a non-steroidal mineralocorticoid receptor antagonist (nsMRA) that selectively and potently blocks mineralocorticoid receptor overactivation in the heart and kidneys.

Who can take Kerendia?

Kerendia is FDA approved for adults with: 

• chronic kidney disease (CKD) associated with type 2 diabetes (T2D) to reduce the risk of sustained estimated glomerular filtration rate (eGFR) decline, end-stage kidney disease, cardiovascular death, non-fatal myocardial infarction, and hospitalization for heart failure. (10mg, 20mg tablets)
• heart failure left ventricular ejection fraction (HF LVEF) ≥40% to reduce the risk of cardiovascular death, hospitalization for heart failure, and urgent heart failure visits.  (10mg, 20mg, 40mg tablets)

Before taking this medicine

You should not use Kerendia if you are allergic to it, or if you have problems with your adrenal gland.

Some drugs should not be used with this medicine. Your treatment plan may change if you also use:

• nefazodone;
• the antibiotics clarithromycin or telithromycin;
• antifungal medicine--itraconazole, ketoconazole, posaconazole, voriconazole; or
• antiviral medicine for HIV or hepatitis C--boceprevir, cobicistat, dasabuvir, elvitegravir, indinavir,
• lopinavir/ritonavir, nelfinavir, ombitasvir, paritaprevir saquinavir, telaprevir, tipranavir.

Tell your doctor if you have ever had:

• severe liver disease; or
• high blood levels of potassium (hyperkalemia).

It is not known if finerenone will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

You should not breastfeed while using finerenone, and for at least 1 day after your last dose.

Not approved for use by anyone younger than 18 years old.

How should I take Kerendia?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

You may take finerenone with or without food.

If you cannot swallow a tablet whole, crush the tablet and mix it with water or soft food such as applesauce. Swallow the mixture right away.

You will need medical tests.

What happens if I miss a dose?

Take the missed dose on the same day you remember it. Take your next dose at the regular time and stay on your once-daily schedule. Do not take 2 doses in one day.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking Kerendia?

Do not take potassium supplements or use salt substitutes, unless your doctor has told you to.

Grapefruit may interact with finerenone and cause side effects. Avoid consuming grapefruit products.

Kerendia side effects

Get emergency medical help if you have signs of an allergic reaction to Kerendia: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Treatment with Kerendia may cause serious side effects. Call your doctor at once if you have:

• high blood potassium--nausea, weakness, tingly feeling, chest pain, irregular heartbeats, loss of movement; or
• low blood sodium--headache, confusion, problems with thinking or memory, weakness, feeling unsteady.

Common Kerendia side effects may include:

• high potassium;
• low sodium; or
• low blood pressure.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Related/similar drugs

Kerendia dosing information

Usual Adult Dose for Chronic Kidney Disease

Initial dose:

• For estimated glomerular filtration rate (eGFR) at least 60 mL/min/1.73 m2: 20 mg orally once a day
• For eGFR 25 to less than 60 mL/min/1.73 m2: 10 mg orally once a day
• For eGFR less than 25 mL/min/1.73 m2: initiation is not recommended

Target dose:

• 20 mg orally once a day

Comments:

Initiation of therapy is not recommended if serum potassium is greater than 5 mEq/L.

Monitoring and Dosage Adjustment 

Measure serum potassium 4 weeks after initiating treatment and periodically throughout treatment, and adjust dose according to detailed dosage instructions.

Usual Adult Dose for Heart Failure with LVEF ≥ 40%

Target dose:

• is dependent on renal function (eGFR) at initiation of Kerendia treatment, according to detailed dosage instructions.
• The target daily dose is 40 mg orally once daily if eGFR at initiation is ≥ 60 mL/min/1.73m2.
• The target daily dose is 20 mg orally once daily if eGFR at initiation is ≥ 25 to < 60 mL/min/1.73m2.
• Measure serum potassium and eGFR 4 weeks after initiating treatment and adjust dose according to detailed dosage instructions. 
• Measure serum potassium and eGFR 4 weeks after a dose adjustment and monitor periodically throughout treatment, and adjust the dose as needed.

What other drugs will affect Kerendia?

Many drugs can affect Kerendia, and some drugs should not be used at the same time. Tell your doctor or pharmacist about all other medicines you use. This includes prescription and over-the-counter medicines, vitamins, and herbal products. 

You should not take Kerendia if you:

Take certain medications called CYP3A4 inhibitors. Ask your healthcare provider if you are not sure if you are taking any of these medications.

• Administration of Kerendia with strong inhibitors of CYP3A4 (such as clarithromycin, itraconazole, ketoconazole, voriconazole, posaconazole, voriconazole, ritonavir, lopinavir, cobicistat) should be avoided.
• Administration of Kerendia with moderate and weak inhibitors of CYP3A4 (such as amiodarone, erythromycin, fluconazole, diltiazem, verapamil, conivaptan) should only be used under medical supervision so that potassium levels can be monitored and dosages adjusted if needed.

Not all possible interactions are listed here, use the link below to check for other Kerendia drug interactions.

How should I store Kerendia?

Store Kerendia at room temperature between 68°F to 77°F (20°C to 25°C).

What are the ingredients in Kerendia?

Active ingredient: finerenone

Inactive ingredients: lactose monohydrate, cellulose microcrystalline, croscarmellose sodium, hypromellose, magnesium stearate, and sodium lauryl sulfate.

The film coating contains hypromellose, titanium dioxide and talc, in addition to ferric oxide red (10 mg strength tablets) or ferric oxide yellow (20 mg strength tablets).

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Further information

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