When should I take Kerendia?
You will take your Kerendia tablets once daily by mouth with or without food. You can take it at any time of the day, but it's best to take it at about the same time each day. This helps to keep drug levels steady and maintain its effectiveness.
Your healthcare provider will determine the correct dose for you based on your kidney function and may increase your dose after 4 weeks. Before and after treatment starts, your doctor will monitor your potassium levels and kidney function with lab tests, as needed. Learn more about Kerendia dosing here.
If you 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.
If you are unable to swallow the tablets whole, you may crush them and mix with water or soft foods such as applesauce right before you take it.
Talk to your doctor before using potassium supplements or salt substitutes containing potassium.
Grapefruit or grapefruit juice may interact with finerenone (Kerendia) and cause side effects. You should avoid the consumption of grapefruit products with Kerendia as it may increase blood levels of the drug
There are many other possible drug interactions with Kerendia, so be sure your pharmacist reviews all the medicines you take, including prescription, over-the-counter (OTC), vitamins and herbal and dietary supplements. Drug interactions may increase the risk of side effects or lower the effectiveness of Kerendia.
Because of potential side effects to breastfed infants from exposure to Kerendia, avoid breastfeeding during treatment and for 1 day after treatment.
Why is Kerendia prescribed?
Kerendia is prescribed in adults 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 (finerenone) is classified as a non-steroidal, selective mineralocorticoid receptor antagonist (MRA) and is approved by the FDA to reduce the risk of:
- worsening kidney disease or kidney failure, cardiovascular (heart-related) death, nonfatal myocardial infarction (heart attack), and hospitalization for heart failure in adult patients with chronic kidney disease (CKD)
associated with type 2 diabetes (T2DM) - cardiovascular death, hospitalization for heart failure, and urgent heart failure visits in adult patients with heart failure with left ventricular ejection fraction (LVEF) ≥ 40%.
Kerendia is thought to work by blocking the overactivation of the mineralocorticoid receptor found on the kidney that may contribute to fibrosis (scarring), inflammation and permanent kidney damage.
As shown in Phase 3 studies reviewed by the FDA for approval, Kerendia is used to lower the risk of:
- worsening of kidney disease
- kidney failure
- death due to cardiovascular (heart-related) disease
- heart attack
- hospitalization and urgent visits for heart failure
The Kerendia label warns about the risk of hyperkalemia (high potassium levels), a common side effect. Hyperkalemia occurred in 18.3% of patients taking Kerendia compared to 9% on placebo. Kerendia can also cause worsening of kidney function in some patients with heart failure.
Other common side effects include hypotension (low blood pressure), hyponatremia (low sodium levels) and hyperkalemia (high potassium levels).
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What is chronic kidney disease?
Chronic kidney disease (CKD) occurs when your kidneys do not work properly and this worsens over time. Your kidneys help to filter out waste products and fluids from your body through your urine. When your kidney do not work properly, dangerous levels of fluid, electrolytes and wastes can build up in your body
People with type 2 diabetes have an increase risk of having chronic kidney disease. CKD may occur without any symptoms in the early stages, and may lead to the need for dialysis or a kidney transplant. Early treatment may prevent worsening kidney function.
Symptoms of CKD include:
- nausea / vomiting
- loss of appetite
- fatigue and weakness
- trouble sleeping
- urinating less or more frequently
- muscle cramps
- inability to focus
- swelling of feet and ankles
- dry or itchy skin
- high blood pressure (hypertension)
- shortness of breath
- chest pain
If you have diabetes it is important to get your kidneys checked regularly by your doctor, even if you do not have symptoms. They will monitor your kidney health with regular blood and urine tests.
What is heart failure with LVEF ≥ 40%?
Heart failure with left ventricular ejection fraction (LVEF) ≥ 40% means the heart muscle is not pumping blood as well as it should be, but it is still pumping out at least 40% of blood with each heart beat. The heart is weakened but can still pump a certain amount of blood to tissues and organs to help deliver oxygen.
Medically this is called a mildly reduced ejection fraction (when LVEF is 40% to 49%) and a preserved ejection fraction (when LVEF is ≥ 50%). Your ejection fraction can tell your doctor how well your heart is working, and lower numbers show an increased risk for heart failure.
Symptoms of heart failure include:
- abnormal heart beat (palpitations)
- feeling confused
- feeling weak
- feeling sleepy or tired
- upset stomach or nausea
- shortness of breath
- fluid retention or swelling (in feet or stomach)
Call your doctor if you have any of these symptoms, particularly if you already have been diagnosed with heart disease.
This is not all the information you need to know about Kerendia (finerenone) for safe and effective use and does not take the place of your doctor’s directions. Review the full product information and discuss this information and any questions you have with your doctor or other health care provider.
References
- Kerendia (finerenone) prescribing information. July 2025. Bayer HealthCare Pharmaceuticals Inc. Whippany, NJ. Accessed July 15, 2025 at https://labeling.bayerhealthcare.com/html/products/pi/Kerendia_PI.pdf
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