Finerenone

Finerenone is a nonsteroidal mineralocorticoid receptor antagonist medicine available in Bangladesh under many brand names. Below are its uses, dosage, side effects and precautions — and all brands with their current prices.

• To reduce the risk of sustained decline in kidney function, end-stage kidney disease, cardiovascular death, non-fatal heart attack, and hospitalization for heart failure in adults with chronic kidney disease associated with type 2 diabetes.

For adults, Finerenone is usually taken once daily, with or without food. The starting dose and any dose adjustment depend on kidney function and blood potassium level, and blood tests are needed before starting and during treatment. Follow the prescribing doctor’s instructions exactly; do not start, stop, or change the dose without medical advice.

• High blood potassium level, which may cause weakness, nausea, numbness, slow or irregular heartbeat, or may have no symptoms.
• Low blood pressure or dizziness.
• Low blood sodium level.
• Changes in kidney function blood tests.
• Seek urgent medical help for severe dizziness, fainting, palpitations, muscle weakness, or signs of an allergic reaction such as swelling, rash, or breathing difficulty.

Use Finerenone carefully in people with kidney impairment, a history of high potassium, heart failure, low blood pressure, or liver disease. Potassium and kidney function should be checked before starting and regularly during treatment. Avoid potassium supplements or potassium-containing salt substitutes unless specifically prescribed. Use this medicine only under the guidance of a registered doctor or pharmacist.

• Strong CYP3A4 inhibitors such as ketoconazole, itraconazole, clarithromycin, ritonavir, or cobicistat can greatly increase Finerenone levels and should not be used together.
• Moderate or weak CYP3A4 inhibitors such as erythromycin, verapamil, diltiazem, fluconazole, or grapefruit products may increase levels and require medical review.
• Strong or moderate CYP3A4 inducers such as rifampicin, carbamazepine, phenytoin, phenobarbital, or St John’s wort may reduce effectiveness and are generally avoided.
• Potassium supplements, potassium salt substitutes, potassium-sparing diuretics, and other medicines that raise potassium can increase the risk of hyperkalemia.
• ACE inhibitors or ARBs are commonly used in this patient group but can also raise potassium, so monitoring is important.

• Known hypersensitivity to Finerenone or any component of the product.
• Concomitant use with strong CYP3A4 inhibitors.
• Adrenal insufficiency.
• It should generally not be started if blood potassium is high; the doctor will decide based on current laboratory results.

There is limited human information on use of Finerenone during pregnancy, and animal studies have shown potential harm at clinically relevant exposures. It should be used in pregnancy only if the doctor decides the potential benefit justifies the potential risk. Breastfeeding is not recommended during treatment and for at least 1 day after the last dose, unless a doctor advises otherwise.

Store tablets at room temperature, away from excess heat, moisture, and direct light. Keep in the original pack, out of reach of children, and do not use after the expiry date.