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Finelidone can block the effect of aldosterone on the mineralocorticoid receptor (MR) with high selectivity and strong affinity, thereby lowering blood pressure and reducing cardiac burden.
1. Generic name: Finerenone (Finerenone)
2. Trade name: Kerendia
< h2>2. IndicationsIt is used to reduce the risk of continued decline in renal function, end-stage renal disease, cardiovascular death, non-fatal myocardial infarction and hospitalization for heart failure in adults with type 2 diabetes (T2D)-related chronic kidney disease (CKD).
10 mg film-coated tablets
Active ingredient: fenelinone; excipients include lactose, microcrystalline cellulose, etc., and the film coating contains hypromellose, iron oxide red (10mg) or iron oxide yellow (20mg).
1. Initial dose : Based on eGFR selection, 20 mg once a day for those with eGFR ≥ 60 mL/min/1.73 m²; 10 mg once a day for those with eGFR 25-<60 mL/min/1.73 m²; not recommended for those with eGFR < 25 mL/min/1.73 m².
2. Target dose : Adjust to 20 mg once daily after 4 weeks (blood potassium and eGFR need to be monitored).
3. How to take : Can be taken with food or on an empty stomach. Swallow the tablet whole or crush it and mix it with water/soft food.
1. Serum potassium ≤ 4.8mEq/L : can be increased from 10mg to 20mg.
2. Serum potassium >4.8-5.5mEq/L : Maintain the current dose; suspend administration when >5.5mEq/L, restart 10mg after serum potassium ≤5.0mEq/L.
3. How to deal with missed doses : Take the missed dose on the same day, otherwise skip the next day and take the medicine as originally planned.
1. Diet : Avoid grapefruit/grapefruit juice (increases blood drug concentration).
2. Monitor : Monitor serum potassium and eGFR regularly before and during medication.
3. Vomiting/absorption effects : Not clearly stated, it is recommended to consult a physician.
1. Pregnant women : No human data, animals show fetal toxicity, avoid use.
2. Lactation : Avoid breastfeeding within 1 day after stopping the drug.
3. Elderly : No need to adjust the dose.
4. U200c for patients with liver damage: It is disabled for severe liver damage (Child-PughC); no adjustment is needed for mild to moderate liver damage (A/B), but serum potassium monitoring is required for moderate.
Common (≥1% and higher than placebo): hyperkalemia (14%), hypotension (4.6%), hyponatremia (1.3%).
1. Combined use of strong CYP3A4 inhibitors (such as ketoconazole).
2. Patients with adrenal insufficiency.
1. CYP3A4 inhibitor : Strong (contraindicated), moderately weak (need to monitor serum potassium).
2. CYP3A4 inducer : Strong and moderately effective (avoid combined use).
3. Potassium-raising drugs : Such as potassium supplements and potassium-sparing diuretics, blood potassium needs to be closely monitored.
Store at room temperature of 20-25℃, allowing short-term fluctuation of 15-30℃.