Kerendia is a brand-name prescription medication. It’s FDA-approved to help reduce the risk of complications in adults with chronic kidney disease (CKD) related to type 2 diabetes.

These complications may include worsening kidney function, heart attack, and hospitalization for heart failure. They may also include end stage kidney disease and death due to cardiovascular problems such as stroke.

Drug details

Kerendia belongs to a drug class called nonsteroidal mineralocorticoid receptor antagonists (MRAs). The active ingredient in Kerendia is finerenone.

Kerendia is available as an oral tablet. It comes in two strengths: 10 milligrams (mg) and 20 mg.

FDA approval

The Food and Drug Administration (FDA) approved Kerendia in 2021. At this time, Kerendia is the only nonsteroidal MRA approved to help prevent complications related to CKD from type 2 diabetes.

Effectiveness

For information about the effectiveness of Kerendia, see the “Kerendia uses” section below.

Kerendia is available only as a brand-name medication. It’s not currently available in generic form.

A generic drug is an exact copy of the active drug in a brand-name medication. Generics typically cost less than brand-name drugs.

Kerendia can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Kerendia. These lists do not include all possible side effects.

For more information about the possible side effects of Kerendia, talk with your doctor or pharmacist. They can give you tips on how to manage any side effects that may be concerning or bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to notify the FDA about a side effect you’ve had with Kerendia, you can do so through MedWatch.

Mild side effects

Mild side effects*† of Kerendia can include:

Most of these side effects may go away within a few days or a couple of weeks. However, if they become more severe or don’t go away, talk with your doctor or pharmacist.

* This is a partial list of mild side effects from Kerendia. To learn about other mild side effects, talk with your doctor or pharmacist, or view Kerendia’s prescribing information.
† For more information about these side effects, see “Side effect details” below.

Serious side effects

Serious side effects from Kerendia aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects* and their symptoms can include:

* For more information about these side effects, see “Side effect details” below.

Side effect details

Here’s some detail on certain side effects this drug may cause. To find out how often side effects occurred in clinical trials, see the prescribing information for Kerendia.

High levels of potassium in the blood

Some people may develop high levels of potassium in the blood from taking Kerendia. This was a common side effect reported in people who took Kerendia in clinical trials.

In some cases, high blood potassium levels may be serious. It’s important that you’re aware of possible symptoms so you can tell your doctor right away if you have them. Symptoms of high blood potassium levels may include heart palpitations, difficulty breathing, and chest pain. Other symptoms may include nausea, vomiting, and muscle weakness.

You may be at an increased risk of developing high levels of potassium in the blood if you:

  • have reduced kidney function
  • have high blood potassium levels when you start taking Kerendia
  • have other medical conditions that increase your blood potassium levels, such as diabetes that isn’t currently managed or treated
  • are taking other medications that also increase your blood potassium levels, including ACE inhibitors* such as lisinopril (Prinivil, Zestril)

Before you start taking Kerendia, your doctor will measure your blood potassium level and kidney function with a blood test. In some cases, they may adjust your dose or recommend a different treatment option for you based on the results.

Your doctor will also use blood tests monitor you throughout your treatment with Kerendia. In some cases, your doctor may adjust your dose of Kerendia if your blood potassium level becomes high. If you’re at increased risk of developing a high potassium level in your blood, your doctor may monitor your blood potassium level more often.

If you have additional questions or concerns about Kerendia and blood potassium levels, talk with your doctor.

* ACE inhibitors stands for angiotensin converting enzyme inhibitors.

Low blood pressure

Hypotension (also known as low blood pressure) was a common side effect reported in clinical trials of people taking Kerendia.

Symptoms of low blood pressure may include:

If you develop symptoms of low blood pressure, talk with your doctor right away. Your doctor should be able to treat your blood pressure to bring it back to a normal level.

Low levels of sodium in the blood

It’s possible to develop low levels of sodium in the blood from taking Kerendia. This was a common side effect that people taking Kerendia experienced in clinical trials.

Symptoms of low blood sodium levels may include:

  • nausea or vomiting
  • headache
  • muscle weakness or cramps
  • seizures

If you experience symptoms of a low blood sodium level, you should talk with your doctor right away. They can order a blood test to check your level. If your blood sodium level is low, depending on the cause, your doctor may prescribe treatment. This can include reducing the amount of fluid you drink or taking salt tablets.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Kerendia.

Symptoms of a mild allergic reaction can include:

A more severe allergic reaction is rare, but it is possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing

Call your doctor right away if you have an allergic reaction to Kerendia, as the reaction could become severe. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

As with all medications, the cost of Kerendia can vary. To find current prices for Kerendia tablets in your area, check out GoodRx.com.


The cost you find on GoodRx.com is what you may pay without insurance. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Keep in mind that you may be able to get a 90-day supply of Kerendia. If approved by your insurance company, getting a 90-day supply of the drug could reduce your number of trips to the pharmacy and help lower the cost. If you’re interested in this option, check with your doctor, pharmacist, or insurance company.

Before approving coverage for Kerendia, your insurance company may require you to get prior authorization. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide if the drug will be covered.

If you’re not sure whether you’ll need to get prior authorization for Kerendia, contact your insurance company.

Financial and insurance assistance

If you need financial support to pay for Kerendia, or if you need help understanding your insurance coverage, help is available.

Bayer, the manufacturer of Kerendia, offers a savings card and a patient support program that may help make the drug more affordable for you. For more information and to find out if you’re eligible for support, call 888-537-3634 or visit the program website.

To learn more about saving money on prescriptions, check out this article.

Mail-order pharmacies

Kerendia may be available through a mail-order pharmacy. Using this service may help lower the drug’s cost and allow you to get your medication without leaving home.

If recommended by your doctor, you may be able to receive a 90-day supply of Kerendia, so there’s less concern about running out of the medication. If you’re interested in this option, check with your doctor, pharmacist, or insurance company. Some Medicare plans may help cover the cost of mail-order medications.

If you don’t have insurance, you can ask your doctor or pharmacist about online pharmacy options.

Generic version

Kerendia is not available in a generic form. A generic drug is an exact copy of the active drug in a brand-name medication. Generics tend to cost less than brand-name drugs.

The Kerendia dosage your doctor prescribes will depend on several factors. These include:

  • your kidney function
  • your blood potassium level
  • other medications that you take

Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug forms

Kerendia comes as an oral tablet.

Drug strengths (10 mg and 20 mg)

Kerendia comes in two strengths: 10 milligrams (mg) and 20 mg.

Dosage for kidney disease related to type 2 diabetes

Kerendia is approved to reduce the risk of complications from chronic kidney disease (CKD) related to type 2 diabetes. The recommended dosage for this use is 10 mg or 20 mg per day. Your doctor will recommend the best starting dose for you based on your kidney function tests.

Your doctor will use your estimated glomerular filtration rate (eGFR) to determine your kidney function.

Below is a table showing the recommended starting dosages of Kerendia.

eGFRStarting dosage
60 or more20 mg per day
25 to less than 6010 mg per day
Less than 25different treatment option is recommended*

* Your body gets rid of Kerendia primarily through urine. If your kidney function is too low, it may lead to a buildup of Kerendia in your system. This can increase your risk of side effects, so your doctor will likely recommend a different treatment option.

Your doctor will order a blood test to check your blood potassium level 4 weeks after you start Kerendia treatment. In some cases, they may adjust your dose of Kerendia.

What if I miss a dose?

If you miss a dose of Kerendia, take it as soon as you remember, as long as it’s the same day. If you missed your dose from a different day, skip the missed dose and take your next dose at the regularly scheduled time.

If you have questions about when to take your next dose of Kerendia after missing a dose, talk with your doctor or pharmacist.

To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm or using a timer. You could also download a reminder app on your phone.

Will I need to take this drug long term?

Kerendia is meant to be a long-term treatment. If you and your doctor determine that Kerendia is safe and effective for you, you’ll likely take it long term.

Kerendia is prescribed to help reduce the risk of complications in people with chronic kidney disease (CKD) related to type 2 diabetes. CKD occurs when your kidneys cannot properly filter your blood. This can cause symptoms such as swelling of your hands or feet, difficulty breathing, or changes in your urination.

Having type 2 diabetes can increase your risk of developing CKD. With type 2 diabetes, your blood sugar level become too high. Over time, high blood sugar levels can damage the blood vessels in your kidneys.

The problems related to CKD that Kerendia is used to help prevent affect the heart and kidneys.

These problems can occur from swelling or scarring in your kidneys, heart, or blood vessels. The swelling or scarring may be due to too much activity in your mineralocorticoid receptors (MRs). MRs are proteins that help manage blood pressure. MRs also help maintain electrolyte and fluid balance in the body. (Electrolytes are chemicals that help keep your body hydrated.)

What’s Kerendia’s mechanism of action?

Kerendia’s mechanism of action (how it works) is to decrease the activity of your MRs. Too much MR activity can cause swelling or scarring. By blocking this activity, Kerendia can decrease your risk of swelling and scarring.

This can also lead to reducing your chances of developing related conditions, such as end stage kidney disease, hospitalization from heart failure, or heart attack.

How long does it take to work?

Kerendia will begin working as soon as you take your first dose of medication.

Because Kerendia works to reduce your risk of complications, you may not notice a difference in how you feel after you start taking the drug. For this reason, it’s important to talk with your doctor before you start treatment. They can advise you on what to expect from the medication.

Other drugs are available that can treat your condition. Some may be a better fit for you than others. If you’re interested in finding an alternative to Kerendia, talk with your doctor. They can tell you about other medications that may work well for you.

Alternatives for kidney disease related to type 2 diabetes

Kerendia is prescribed to reduce the risk of certain complications in people with chronic kidney disease that’s related to type 2 diabetes. Here are examples of other drugs prescribed for that purpose:

Spironolactone (Aldactone) may also be used to help reduce the risk of hospitalization due to heart failure.

The Food and Drug Administration (FDA) approves prescription drugs such as Kerendia to treat certain conditions.

Kerendia for kidney disease related to type 2 diabetes

Kerendia is approved to reduce the risk of complications in people with chronic kidney disease (CKD) from type 2 diabetes. These complications may include:

CKD occurs when your kidneys can’t properly filter your blood. CKD is a slow loss of kidney function over years, and it eventually may develop into kidney failure. CKD can cause symptoms such as swelling of your hands or feet, difficulty breathing, or changes in urination.

Having type 2 diabetes can increase your risk of developing CKD. With type 2 diabetes, your blood sugar level becomes too high. Over time, high blood sugar levels can damage the blood vessels in your kidneys.

For more information about diabetes, see our diabetes hub.

Effectiveness for reducing complications from kidney disease related to type 2 diabetes

Kerendia has been found to be an effective treatment to help reduce the risk of complications from CKD related to type 2 diabetes.

For information on how Kerendia performed in clinical trials, see the drug’s prescribing information.

Drinking alcohol during treatment with Kerendia may increase your risk of side effects. For example, alcohol and Kerendia can both cause low levels of sodium in the blood.

In addition, drinking alcohol can cause your blood sugar level to become too high or too low. This can be a concern if your levels aren’t well managed. Kerendia is used in people with type 2 diabetes, and this condition can make it hard to manage blood sugar levels.

Talk with your doctor about how much alcohol, if any, is safe for you to drink during treatment with Kerendia.

Kerendia can interact with several other medications. It can also interact with certain supplements as well as certain foods.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.

Kerendia and other medications

Below is a list of medications that can interact with Kerendia. This list does not contain all drugs that may interact with Kerendia.

Before taking Kerendia, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also, tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Serious drug interactions with Kerendia

There are certain drugs that your doctor may not prescribe with Kerendia, including:

Strong CYP3A4 inhibitors. When Kerendia is taken with a drug called a strong CYP3A4 inhibitor, this can increase the risk of side effects from Kerendia. Due to this possible interaction, doctors will not prescribe Kerendia with strong CYP3A4 inhibitors.

CYP3A4 inhibitors may be prescribed for a variety of different conditions, including infections and depression. Examples of strong CYP3A4 inhibitors include:

Moderate drug interactions with Kerendia

Other types of drugs that can interact with Kerendia include:

Moderate and weak CYP3A4 inhibitors. When Kerendia is taken with a drug called a moderate or weak CYP3A4 inhibitor, this can increase the risk of side effects from Kerendia. Your doctor may monitor your blood potassium levels or make dosage adjustments to help reduce this risk.

Moderate or weak CYP3A4 inhibitors may be prescribed for a variety of different conditions, such as infections or heart conditions. Examples of these drugs may include:

Moderate and strong CYP3A4 inducers. When Kerendia is taken with a drug called a moderate or strong CYP3A4 inducer, Kerendia may not work as well as intended. Because of this interaction, your doctor may not prescribe moderate or strong CYP3A4 inducers while you take Kerendia.

Moderate or strong CYP3A4 inducers may be prescribed for conditions such as seizure disorders or infections. Examples of these drugs may include:

Drugs that increase your blood potassium levels. High potassium levels in the blood are a potential side effect of Kerendia. So taking drugs that increase your blood potassium levels in combination with Kerendia can increase the risk of that side effect. Your doctor may monitor your blood potassium levels more often if you take these drugs with Kerendia.

Drugs that increase your blood potassium levels can include blood pressure medications, nonsteroidal anti-inflammatory drugs (NSAIDs), and diuretics. Examples of these medications may include:

Kerendia and herbs and supplements

Kerendia may interact with a supplement called St. John’s Wort, which may be taken to treat depression. St. John’s Wort is a type of drug called a strong CYP3A4 inducer. (To learn more, see “Other drugs that could cause an interaction with Kerendia” above.) You can talk with your doctor about treatments other than St. John’s wort.

Kerendia and foods

You should avoid grapefruit and grapefruit juice while you take Kerendia. Consuming grapefruit or grapefruit juice can decrease your body’s ability to break down Kerendia. This means that too much of the drug can build up in your body, possibly increasing your risk of side effects.

You should take Kerendia according to the instructions your doctor gives you.

Kerendia is an oral tablet that you swallow whole.

When to take

You should take your dose of Kerendia once daily, at about the same time each day. Taking the medication around the same time of day helps keep a steady level of the drug in your body. This helps Kerendia work effectively.

To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm or using a timer. You could also download a reminder app on your phone.

Accessible labels and containers

If your prescription label is hard to read, talk with your doctor or pharmacist. Some pharmacies offer labels that have large print, braille, or a code you scan with a smartphone to convert text to speech. If your local pharmacy doesn’t have these options, your doctor or pharmacist may be able to direct you to one that does.

If you have trouble opening medication bottles, ask your pharmacist if they can put Kerendia in an easy-open container. They also may be able to recommend tools that can make it simpler to open lids.

Taking Kerendia with food

You can take your dose of Kerendia with or without food.

Can Kerendia be crushed, split, or chewed?

If you’re having trouble swallowing your dose of Kerendia, you can crush the tablet and mix it with water or other soft foods such as applesauce. After crushing and mixing the tablet, you should take your dose of Kerendia right away.

It’s not known if Kerendia is safe to take during pregnancy. At this time, there have not been any clinical trials involving pregnant people to see whether Kerendia increases the risk of congenital anomalies (commonly known as birth defects).

Animal trials showed an increased risk of problems with fetal development in the offspring of pregnant animals given Kerendia. However, animal trials do not always indicate what may happen in humans.

If you are pregnant or planning to become pregnant, talk with your doctor before taking Kerendia. They can advise you on your treatment options.

Kerendia and fertility

It’s not known if Kerendia affects fertility in humans. In animal trials, this medication did not affect the fertility of male animals. However, the drug decreased the fertility of female animals.

If you’re concerned about Kerendia and your fertility, talk with your doctor.

It’s not known if Kerendia is safe to take during pregnancy. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re using Kerendia.

For more information about taking Kerendia during pregnancy, see the “Kerendia and pregnancy” section above.

Breastfeeding is not recommended while you’re taking Kerendia and for at least 1 day after stopping treatment. This is because it’s not known if Kerendia may be safe to take while breastfeeding. It’s also not known if the drug passes into breast milk or what effects it may have on a child who is breastfed.

In animal trials, Kerendia passed into breast milk. Animal trials do not always indicate what may happen in humans. However, since the drug was present in the animal breast milk, it will likely be present in human breast milk as well.

If you’re breastfeeding or planning to breastfeed, talk with your doctor. They can recommend safe and healthy ways to feed your child.

Here are answers to some frequently asked questions about Kerendia.

Will Kerendia cure my kidney disease?

Kerendia will not cure your kidney disease. This medication is used in people with chronic kidney disease (CKD) that’s related to type 2 diabetes.

Although this medication may help prevent conditions such as end stage kidney disease and heart attack, Kerendia does not treat CKD. At this time, there is no cure for CKD.

Talk with your doctor if you have questions or concerns about treatment for kidney disease.

Does Kerendia cause long-term side effects?

Kerendia is not currently known to cause any long-term side effects. Most of the side effects that you may experience with Kerendia should ease after you stop treatment with the medication.

If you’re concerned about Kerendia’s side effects, talk with your doctor. They can discuss the possible side effect risks of taking this medication.

How long will I need to take Kerendia?

Kerendia is prescribed long term to reduce the risk of complications of CKD related to type 2 diabetes. Since CKD is lifelong, Kerendia is typically used as a long-term treatment option. If this medication is working for you, your doctor will likely recommend that you take it long term.

Talk with your doctor about your treatment plan to see how long they may recommend you take Kerendia.

Before taking Kerendia, talk with your doctor about your health history. Kerendia may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • Severe kidney problems. Kerendia is prescribed for people with chronic kidney disease related to type 2 diabetes. You may be at an increased risk of developing serious side effects, such as high levels of potassium in the blood, if you have other severe kidney problems. Your doctor can help you determine if Kerendia may be a safe treatment option for you.
  • High blood potassium levels. Kerendia may cause high blood potassium levels, which can be serious. If you already have high blood potassium levels, taking Kerendia may make your condition worse. In this case, your doctor may monitor your blood potassium levels throughout your treatment with Kerendia.
  • Adrenal insufficiency. Doctors typically advise against taking Kerendia if you have adrenal insufficiency. Symptoms of adrenal insufficiency can include low blood pressure, low blood sodium levels, and high blood potassium levels. These are also side effects of Kerendia. This means that you may be at an increased risk of the side effects if you have adrenal insufficiency and take Kerendia. Talk with your doctor about what may be the best treatment option for you.
  • Liver problems. Tell your doctor about any liver problems that you have before you start taking Kerendia. It is not known if Kerendia may be a safe treatment option for people with severe liver problems, such as cirrhosis. Your doctor may not recommend the medication if you have severe liver problems. Talk with your doctor about what medication may be the best treatment option for you.
  • Allergic reaction. If you’ve had an allergic reaction to Kerendia or any of its ingredients, your doctor will likely not prescribe Kerendia. Ask your doctor what other medications may be better options for you.
  • Pregnancy. It is not known if Kerendia may be safe to take during pregnancy. For more information, see the “Kerendia and pregnancy” section above.
  • Breastfeeding. It is not known if Kerendia may be safe to take while you are breastfeeding. For more information, see the “Kerendia and breastfeeding” section above.

Note: For more information about the potential negative effects of Kerendia, see the “Kerendia side effects” section above.

Using more than the recommended dosage of Kerendia can lead to serious side effects.

Do not take more Kerendia than your doctor recommends.

Overdose symptoms

Symptoms of an overdose will likely cause symptoms of high blood potassium levels, which can include:

What to do in case of overdose

If you think you’ve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use its online tool. However, if your symptoms are severe, call 911 or your local emergency number or go to the nearest emergency room right away.

When you get Kerendia from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee that the medication is effective during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk with your pharmacist about whether you might still be able to take it.

Storage

How long a medication remains good to use can depend on many factors, including how and where you store the medication.

You should store Kerendia tablets at room temperature, from 68°F to 77°F (20°C to 25°C). If needed, you can store Kerendia from 59°F to 86°F (15°C to 30°C).

Disposal

If you no longer need to take Kerendia and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

This article provides several useful tips on medication disposal. You can also ask your pharmacist for information about how to dispose of your medication.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.