Medication Guide for Fenelidone: How many tablets should be taken per day for optimal efficacy?

Finerenone is a non-steroidal mineralocorticoid receptor (MR) antagonist, used to treat patients with chronic kidney disease (CKD) combined with type 2 diabetes mellitus (T2DM). Its dosage needs to be adjusted according to the patient's renal function status to ensure efficacy and safety.

The recommended dosage is usually divided into two specifications: 10mg and 20mg. Patients only need to take it orally once a day, with food or on an empty stomach, and there is no need to adjust the medication time. However, the specific dosage needs to be adjusted individually based on the patient's glomerular filtration rate (eGFR) and serum potassium level.

1. Initial dose:

eGFR≥60mL/min/1.73m²: The recommended starting dose is 20mg, once a day.

eGFR 25-59mL/min/1.73m²: The recommended starting dose is 10mg, once a day, which can be increased to 20mg/day after tolerance.

eGFR<25mL/min/1.73m²: Not recommended.

2. Dosage adjustment:

If the serum potassium level rises to 5.5-6.0mmol/L during treatment 5.5-6.0mmol/L, the drug needs to be temporarily stopped or the dose reduced, and the dose needs to be re-evaluated after the serum potassium recovers. If serum potassium is ≥6.0 mmol/L, fenelidone should be discontinued and potassium-lowering measures should be taken.

Since the main role of fenelidone is to reduce proteinuria and cardiovascular risk in patients with chronic kidney disease, it needs to be taken for a long time, and blood potassium levels and kidney function must be regularly monitored. Generally speaking, doctors will regularly check serum potassium before taking medication, after 4 weeks of taking the medication and during subsequent treatment to prevent the occurrence of hyperkalemia.

In general, fenelidone reduces inflammation and fibrosis in the kidneys and cardiovascular system by selectively blockingMR receptors, improves proteinuria, and reduces the risk of cardiovascular complications. It is a new treatment drug for chronic kidney disease with important clinical significance.

Reference materials: https://www.kerendia.com/