finerenone at a glance
Medicine class
Non-steroidal selective mineralocorticoid receptor antagonist
Licensed use
Symptomatic chronic heart failure in adults with LVEF of 40% or higher
Key monitoring
Blood potassium and kidney function
Food
May be taken with or without food, but grapefruit must be avoided
What is finerenone used for?
The selected product is licensed for:
Symptomatic chronic heart failure in adults whose left ventricular ejection fraction is 40% or higher.
How does finerenone work?
Finerenone blocks mineralocorticoid receptors activated by aldosterone and cortisol. This reduces signalling involved in inflammation and fibrosis in the heart and other tissues.
finerenone preparations and strengths
Tablet
Route: Oral
Strengths: 10 mg, 20 mg, 40 mg
How to take finerenone
Take the tablet by mouth as instructed by the prescriber.
Swallow it with water, with or without food.
Do not eat grapefruit or drink grapefruit juice during treatment.
If swallowing is difficult, the tablet may be crushed and mixed with water or soft food such as apple sauce; take the mixture immediately.
finerenone side effects
Common or expected effects
- High potassium detected by blood tests
- Low sodium or high uric acid
- Reduced kidney function or acute kidney injury
- Low blood pressure, sometimes causing dizziness or faintness
- Diarrhoea or constipation
- Changes in creatinine or estimated glomerular filtration rate
Get urgent medical advice
- Severe weakness, nausea, numbness, muscle cramps or an unusually slow heartbeat, which may indicate high potassium
- Fainting or severe light-headedness
- A marked reduction in urine or rapid deterioration in general condition, which may indicate acute kidney injury
finerenone in pregnancy
There are no human pregnancy data, and animal studies found reproductive toxicity. Finerenone should not be used during pregnancy unless clinically necessary after careful consideration of maternal benefit and fetal risk. Effective contraception is advised during treatment; contact the prescriber promptly if pregnancy occurs.
finerenone while breastfeeding
It is unknown whether finerenone enters human milk, and a risk to the infant cannot be excluded. The prescriber and patient should decide whether to stop breastfeeding or avoid finerenone, considering the benefits of each.
finerenone interactions
A complete medicines review is important because finerenone is mainly metabolised by CYP3A4 and can raise potassium.
Strong CYP3A4 inhibitors, including clarithromycin, itraconazole, ketoconazole, ritonavir and cobicistat
Contraindicated because they can markedly increase finerenone exposure.
Rifampicin, carbamazepine, phenytoin, phenobarbital, efavirenz and St John’s wort
Avoid because CYP3A4 induction can reduce finerenone exposure and effectiveness.
Spironolactone, eplerenone and other mineralocorticoid receptor antagonists
Do not combine because the risk of high potassium increases.
Common questions about finerenone
Answers are fully visible for fast scanning and source review.
What is finerenone used for in the United Kingdom?
The selected product is licensed for symptomatic chronic heart failure in adults with a left ventricular ejection fraction of 40% or higher.
Is finerenone a steroid?
No. It is described as a non-steroidal mineralocorticoid receptor antagonist.
Why are blood tests needed with finerenone?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.