Why Fenelidone Tablets (Keshenda) is called a banned drug and its usage restrictions

Finerenone (Finerenone) is an oral selective nonsteroidal mineral corticoid receptor antagonist (MRA), mainly used for cardiorenal protective treatment in patients with chronic kidney disease and 2 type diabetes. Its mechanism of action is to reduce renal inflammation and fibrosis by inhibiting excessive activation of mineralocorticoid receptors, thereby delaying the deterioration of renal function. Although its efficacy is clear, its use is strictly limited due to its potential risks.

Finelidone is called a "banned drug" by some media or the public in some countries or regions. The main reason is that it may cause serious side effects such as hyperkalemia, abnormal renal function or hypotension. If not carefully monitored and managed, these risks can be life-threatening, especially in patients with renal insufficiency or hyperkalemia. Since it has not yet been fully marketed in China, the public has limited understanding of its safety and usage regulations, which has also increased the spread of misunderstandings and "banned drug" labels.

Clinically, the use of fenelidone needs to follow strict indications and contraindications. It is suitable for patients with chronic kidney disease who have normal or slightly elevated serum potassium levels and stable renal function. Contraindications include: patients with significantly elevated serum potassium, severe renal insufficiency (such aseGFR<15 mL/min/1.73m²), and patients taking other high-potassium drugs at the same time who cannot be monitored. In addition, pregnant women, lactating women and those with drug allergies are also prohibited from using it.

When using fenelidone, it should be done under the guidance of a professional doctor. During treatment, serum potassium, renal function and blood pressure need to be monitored regularly. If there is an increase in serum potassium or worsening of renal function, the dose should be adjusted immediately or the drug should be temporarily discontinued. Patients should strictly follow the doctor's instructions, not increase or decrease the dosage on their own, and inform the doctor of all concomitant medications and underlying diseases. With good management and monitoring, most patients can use fenelidone safely while reducing cardiorenal risks.

Reference link:https://www.drugs.com