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Malignant hypertension — ESENeph MCQ

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HardHypertension and Renovascular DiseaseMalignant hypertensionESENeph

A patient established on finerenone for diabetic CKD develops severe community-acquired pneumonia. Clarithromycin is proposed while potassium and eGFR are stable. What is the relevant prescribing decision?

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Correct answer: D — Avoid co-administration because clarithromycin is a contraindicated strong CYP3A4 inhibitor

Explanation lettering: E = shown as B · B = shown as C · C = shown as D · D = shown as E

C is correct. Finerenone is predominantly cleared by CYP3A4, and clarithromycin is listed among strong CYP3A4 inhibitors for which concomitant treatment is contraindicated because exposure is expected to rise markedly. Dose separation cannot prevent a metabolic interaction. Moderate inhibitors prompt closer potassium monitoring, but that is not the rule for clarithromycin.

Reference: Kerendia 20 mg film-coated tablets SmPC: https://www.medicines.org.uk/emc/product/13438/smpc