FINERENONE
Background and Date of Approval
Finerenone is a medication containing the active ingredient finerenone and belongs to the class of nonsteroidal mineralocorticoid receptor antagonists (MRAs). It works by targeting the effects of mineralocorticoid hormones, particularly aldosterone. The medication is primarily used to treat chronic kidney disease (CKD) in patients with type 2 diabetes. It helps reduce the risk of kidney disease progression and cardiovascular events, including heart failure, in these patients. The U.S. Food and Drug Administration (FDA) initially approved finerenone on May 26, 2021.
Uses
Finerenone is used in the treatment of Chronic kidney disease (CKD) with type 2 diabetes.
How is it administered?
To use Finerenone, follow your healthcare provider's prescribed dosage and instructions. Take the medications as directed, usually orally, with or without food. Do not skip doses or stop taking them without consulting your healthcare provider. Consult your healthcare provider or pharmacist for guidance if you have any questions or concerns.
Side Effects
Common side effects of finerenone may include hyperkalemia (high potassium levels), dizziness, diarrhea, and hypotension (low blood pressure). Hyperkalemia is a potential concern due to the mechanism of action of finerenone as a mineralocorticoid receptor antagonist.
Warnings
Finerenone comes with several warnings. These include the risk of hyperkalemia (high potassium levels), caution in patients with renal impairment, the potential for hypotension (low blood pressure), contraindication in severe liver impairment, the possibility of drug interactions, the need to be cautious in patients with adrenal insufficiency, and the recommendation to avoid its use during pregnancy and breastfeeding. Additionally, finerenone may cause electrolyte imbalances, exacerbate heart failure, affect hormone levels, and can rarely lead to hypersensitivity reactions.
Precautions
Discussing these warnings with your healthcare provider to ensure these medications' safe and appropriate use is essential. When using Finerenone, it is important to adhere to the prescribed dosage and follow the instructions provided by your healthcare provider. Before starting treatment, inform your healthcare provider about any medical conditions, allergies, or medications you are taking. Regular monitoring of liver function and kidney function is advised. If you experience symptoms of a hypersensitivity reaction, such as fever, rash, or respiratory symptoms, discontinue the medication and seek immediate medical attention. Avoid alcohol and be cautious when driving or operating machinery, as these medications may cause dizziness or drowsiness. Consult your healthcare provider before changing your treatment regimen or starting new medications.
Word of Advice
Follow the recommended dosage and instructions for Finerenone use. If you are pregnant, planning pregnancy, or breastfeeding, discuss potential risks and benefits with your doctor. This medicine is generally not recommended during pregnancy and breastfeeding. Unless your doctor advises otherwise, limit intake of high-potassium foods such as bananas, oranges, tomatoes, and salt substitutes. Some patients may experience mood changes or depressive symptoms while taking this medication. Use in elderly patients and children requires special consideration. Adherence and open communication with your healthcare provider ensure safe use of this medication.
References
1. Glenmark Pharmaceuticals Europe Limited, Electronic Medicines Compendium, [Revised on Feb 2021] [Accessed on 27th May 2023], https://www.medicines.org.uk/emc/files/pil.9939.pdf 2. Edward Chu, Cancer Chemotherapy, Langeâs Basic and Clinical Pharmacology, 14th Edition, 2018, 948-976.
Frequently Asked Questions
Can finerenone be used in patients with both heart failure and kidney disease?
Finerenone is specifically indicated for treating heart failure with reduced ejection fraction (HFrEF) in patients with chronic kidney disease (CKD) and type 2 diabetes. It has been shown to provide cardiovascular and renal benefits in this population.
Can finerenone be used in patients with a history of adrenal gland problems?
Finerenone should be used cautiously in patients with adrenal gland problems or insufficiency. Close monitoring may be required, and your healthcare provider will evaluate the potential risks and benefits before prescribing this medication in such cases.
Can finerenone affect hormone levels in the body?
Yes, finerenone can affect hormone levels, particularly those related to the renin-angiotensin-aldosterone system. Your healthcare provider will monitor hormone levels during treatment to ensure they remain within a safe range.
Can finerenone be used in patients with a history of electrolyte imbalances?
Patients with a history of electrolyte imbalances should use finerenone with caution. Regular monitoring of electrolyte levels, particularly potassium, is essential. Your healthcare provider may recommend dietary modifications or prescribe additional medications to help maintain electrolyte balance.
Can finerenone be used in children and adolescents?
The safety and efficacy of finerenone in children and adolescents have not been established. It is primarily indicated for use in adults, and its use in the pediatric population is not recommended.
Can finerenone cause low blood pressure (hypotension)?
The potential side effect of finerenone is low blood pressure, particularly when initiating the medication or increasing the dosage. It is important to inform your healthcare provider if you encounter symptoms such as dizziness, lightheadedness, or fainting. They will assess the situation and may need to adjust your dose or consider additional interventions if required.