Finerenone

Finerenone is used to treat adults with chronic kidney disease (damage to the kidneys which may worsen over time and may cause the kidneys to stop working) due to type 2 diabetes. This treatment may reduce the risk of worsening kidney disease, needing to be hospitalized for heart failure, and life-threatening heart and blood vessel disease or a heart attack. Finerenone is in a class of medications called mineralocorticoid receptor (MR) antagonists. It works by blocking the activity of certain steroids made in the body that can damage the heart and kidneys.

Finerenone comes as a tablet to take by mouth. It is usually taken once a day with or without food. Take finerenone at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take finerenone exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

If you cannot swallow the tablet whole, you may crush the tablet and mix with water or a soft food such as applesauce. The mixture should be taken immediately.

Your doctor will probably start you on a low dose of finerenone and adjust your dose as needed to treat your condition.

Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Before taking finerenone,

• tell your doctor and pharmacist if you are allergic to finerenone, any other medications, or any of the ingredients in finerenone tablets. Ask your pharmacist for a list of the ingredients.
• tell your doctor if you are taking clarithromycin, itraconazole (Sporanox, Tolsura), ketoconazole (Extina, Xolegel), nefazodone, nelfinavir (Viracept), ritonavir (Norvir, in Kaletra), saquinavir (Invirase), tucatinib (Tukysa), and voriconazole (Vfend). Your doctor will probably tell you not to take finerenone if you are taking one or more of these medications.
• some medications should not be taken with finerenone. Other medications may cause dosing changes or extra monitoring when taken with finerenone. Make sure you have discussed any medications you are currently taking or plan to take before starting finerenone with your doctor and pharmacist. Before starting, stopping, or changing any medications while taking finerenone, please get the advice of your doctor or pharmacist
• the following nonprescription or herbal products may interact with finerenone: St. John's wort; potassium supplements. Be sure to let your doctor and pharmacist know that you are taking these medications before you start taking finerenone. Do not start any of these medications while taking finerenone without discussing with your healthcare provider.
• tell your doctor if you have adrenal insufficiency (condition in which the adrenal glands do not produce enough of certain hormones needed for important body functions). Your doctor will probably tell you not to take finerenone.
• tell your doctor if you have high blood levels of potassium or have or have ever had liver disease.
• tell your doctor if you are pregnant or plan to become pregnant. If you become pregnant while taking finerenone, call your doctor.
• tell your doctor if you are breastfeeding. You should not breastfeed during your treatment with finerenone and for 1 day after your final dose.

Do not eat grapefruit or drink grapefruit juice while taking this medication.

Talk to your doctor before using potassium-containing salt substitutes while you are taking this medication.

Take the missed dose as soon as you remember it, but only if it is on the same day. If the missed dose is not taken on the same day, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Finerenone may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• feeling faint or dizziness

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately or get emergency medical treatment:

• muscle cramps or fatigue

Finerenone may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (https://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. https://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (https://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your body's response to finerenone.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

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