Indication
Finerenone is indicated to reduce the risk of sustained eGFR decline, end-stage kidney disease, cardiovascular death, nonfatal myocardial infarction, and hospitalization for heart failure in adult patients with Chronic Kidney Disease (CKD) associated with Type 2 Diabetes (T2D).
Dosage and Administration
Route of administration: Oral.
Prior to Initiation of Fino: Measure serum potassium levels and estimated glomerular filtration rate (eGFR) before initiation. Do not initiate treatment if serum potassium is > 5.0 mEq/L. The recommended starting dose of Fino is based on eGFR and is presented below:
| eGFR (mL/min/1.73m2) | Starting Dose |
| > 60 | 20 mg once daily |
| > 25 to < 60 | 10 mg once daily |
| < 25 | Not Recommended |
For patients who are unable to swallow whole tablets, Finerenone may be crushed and mixed with water or soft foods such as apple sauce immediately prior to use and administered orally.
The target daily dose of Finerenone is 20 mg. Measure serum potassium 4 weeks after initiating treatment and adjust dose if serum potassium levels are > 4.8 to 5.0 mEq/L, initiation of Finerenone treatment may be considered with additional serum potassium monitoring within the first 4 weeks based on clinical judgement and serum potassium levels. Monitor serum potassium 4 weeks after a dose adjustment and throughout treatment, and adjust the dose as needed (see below)
Composition
Finerenone is a nonsteroidal, selective antagonist of the Mineralocorticoid Receptor (MR), which is activated by aldosterone and cortisol and regulates gene transcription. Finerenone blocks MR mediated sodium reabsorption and MR overactivation in both epithelial (e.g., kidney) and nonepithelial (e.g., heart, and blood vessels) tissues. MR overactivation is thought to contribute to fibrosis and inflammation. Finerenone has a high potency and selectivity for the MR and has no relevant affinity for androgen, progesterone, estrogen, and glucocorticoid receptors.