Kerendia interactions: Alcohol, medications, and other factors

Before you start treatment with Kerendia, tell your doctor and pharmacist which prescription, over-the-counter, and other medications you take. By sharing this information with them, you may help prevent possible interactions. (To learn whether Kerendia interacts with supplements, herbs, or vitamins, see the “Kerendia and other interactions” section below.)

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

Here’s a list of drugs that can interact with Kerendia. Keep in mind that this table does not include all drugs that may interact with Kerendia. Some of these interactions are described in detail below in “Drug interactions in depth.”

* To learn about the side effects of Kerendia, see this article.
† For more information about this interaction, see “Drug interactions in depth” below.
‡ For more information about this interaction, see “When to avoid Kerendia” below.

Sometimes, certain factors or conditions could prevent your doctor from prescribing Kerendia due to the risk of harm. These are known as contraindications. The contraindications of Kerendia include:

Taking a medication that strongly inhibits this certain enzyme

Doctors typically won’t prescribe Kerendia in combination with a medication that inhibits the activity of the enzyme CYP3A4.* (An enzyme is a type of protein.) This enzyme helps your body break down Kerendia. Taking Kerendia with a medication that strongly inhibits CYP3A4 could increase the level of Kerendia in your body. This could raise your risk of side effects. (To learn more about Kerendia’s side effects, see this article.)

A few examples include the antibiotic drug clarithromycin and the antifungal drug itraconazole (Sporanox, Tolsura).†

Before you start Kerendia treatment, it’s important to tell your doctor about other medications you take. They’ll advise you whether a specific medication may interact with Kerendia.

* CYP3A4 is short for cytochrome P450 3A4.
† Grapefruit and grapefruit juice can also strongly slow down the activity of CYP3A4. To learn more, see “Kerendia and other interactions” below.

Having adrenal insufficiency

Doctors typically won’t prescribe Kerendia for people with adrenal insufficiency (low adrenal gland function). Both this condition and Kerendia may cause a high blood potassium level. This risk could be even higher if you have this condition and take Kerendia. (To learn more about the side effects of Kerendia, see this article.)

If you have adrenal insufficiency, talk with your doctor before taking Kerendia. They will likely prescribe a different treatment for your condition.

Note: Before you start treatment with Kerendia, it is important to tell your doctor if these contraindications apply to you. They can determine whether to prescribe Kerendia.

There are not any known interactions between Kerendia and alcohol.

However, alcohol may affect blood sugar levels. Doctors prescribe Kerendia to reduce certain risks in people with chronic kidney disease and type 2 diabetes. This means that consuming alcohol during Kerendia treatment may affect the management of blood sugar levels.

If you have questions about drinking alcohol during Kerendia treatment, talk with your doctor.

Here’s a closer look at certain drug interactions of Kerendia.

Amiodarone

Doctors prescribe amiodarone (Nexterone, Pacerone) to treat an irregular heartbeat.

Interaction result. Taking Kerendia with amiodarone can increase the risk of side effects of Kerendia.

Interaction explained. Amiodarone slows down the activity of an enzyme (protein) that helps your body break down Kerendia. Taking Kerendia with amiodarone could increase the level of Kerendia in your system, raising your risk of side effects. This includes an increased risk of having a high blood potassium level. (To learn more about the side effects of Kerendia, see this article.)

Steps you or your doctor may take. Before taking Kerendia, tell your doctor if you take amiodarone. They can tell you whether it’s safe to take these medications together.

Your doctor will check your potassium level with a blood test while you are taking Kerendia. They may test this every 4 weeks or more often if you take Kerendia with amiodarone.

If you have a high blood potassium level while taking Kerendia with amiodarone, your doctor will recommend what to do. For example, they may lower your Kerendia dosage* to reduce the risk of high potassium. Or they may temporarily pause your Kerendia treatment until your potassium level returns to an acceptable range. Your doctor can also advise you on whether it’s safe to continue taking Kerendia with amiodarone.

If you have additional questions about Kerendia and amiodarone, talk with your doctor or pharmacist.

Angiotensin-converting enzyme inhibitors

Doctors prescribe angiotensin-converting enzyme (ACE) inhibitors to treat certain heart and kidney conditions. As with Kerendia, doctors can prescribe ACE inhibitors for people with chronic kidney disease and type 2 diabetes.

Interaction result. Taking Kerendia with an ACE inhibitor may increase the risk of a high blood potassium level with either drug.

Interaction explained. Kerendia may cause a high blood potassium level when you take it by itself. ACE inhibitors may also cause this side effect. Taking the drugs together further increases the risk of high potassium levels. (To learn more about the side effects of Kerendia, see this article.)

Examples of ACE inhibitors. Here are some ACE inhibitors that may interact with Kerendia:

• ramipril (Altace)
• benazepril (Lotensin)
• lisinopril (Qbrelis, Zestril)

Steps you or your doctor may take. Before starting Kerendia treatment, tell your doctor if you take an ACE inhibitor. They’ll recommend whether it’s safe to take these medications together.

During Kerendia treatment, your doctor will check your potassium level with a blood test. They’ll do this at least every 4 weeks. Your doctor may test your level more often if you take Kerendia with an ACE inhibitor. They will recommend what to do if you have a high blood potassium level while taking these medications together.

For example, your doctor may pause your treatment with Kerendia until your potassium level returns to an acceptable range. Or they may adjust your Kerendia dosage* to lower the risk of high potassium. Your doctor can also tell you whether it’s safe to keep taking Kerendia with an ACE inhibitor.

If you have other questions about taking Kerendia with an ACE inhibitor, talk with your doctor or pharmacist.

Certain diuretics

Doctors prescribe diuretics to help your body eliminate sodium (salt) and water. Doctors can prescribe Kerendia and diuretics for people with chronic kidney disease.

Interaction result. You have an increased risk of a high blood potassium level if you take Kerendia with certain diuretics.

Interaction explained. Taking Kerendia may lead to a high blood potassium level. Certain diuretics can also cause this side effect. Taking Kerendia with certain diuretics increases this risk even further. (To learn more about the side effects of Kerendia, see this article.)

Examples of certain diuretics. Here are some diuretics that may interact with Kerendia:

• eplerenone (Inspra)
• triamterene (Dyrenium)
• spironolactone (Aldactone, Carospir)

Steps you or your doctor may take. If you take any diuretics, talk with your doctor before starting Kerendia treatment. They can tell you whether the diuretic you take is safe to take with Kerendia.

Your doctor will check your potassium level with a blood test at least every 4 weeks during Kerendia treatment. They may give you this test more often if you take Kerendia with certain diuretics. If your potassium level is high while taking these drugs together, your doctor will recommend next steps.

Specifically, your doctor may stop your Kerendia treatment for a short time. They will do this until your potassium level returns to an acceptable range. Or your doctor may lower your Kerendia dosage* to reduce the risk of a high potassium level. They will advise whether it is safe to keep taking Kerendia with the diuretic.

If you have other questions about Kerendia and certain diuretics, talk with your doctor or pharmacist.

* To learn about dosage and Kerendia, see this article.

Kerendia may have other interactions, such as with supplements, foods, vaccines, or even lab tests. You’ll find details below. Keep in mind that the following information does not include all other possible interactions with Kerendia.

Kerendia interactions with supplements

Potassium supplements can interact with Kerendia. Both the drug and potassium supplements can cause a high blood potassium level. Taking Kerendia with these supplements can further increase this risk.

Before you start treatment with Kerendia, tell your doctor and pharmacist which supplements, herbs, and vitamins you take. By sharing this information with them, you may help prevent possible interactions.

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

Kerendia interactions with herbs

St. John’s wort may interact with Kerendia. Some people use this herbal supplement to ease symptoms of depression and other conditions.

St. John’s wort may speed up the activity of an enzyme (a type of protein) that helps break down Kerendia. This may lead to a low level of Kerendia in your body. If you take St. John’s wort during Kerendia treatment, it may decrease the effectiveness of Kerendia.

Before you start treatment with Kerendia, tell your doctor and pharmacist which herbs you take. They can recommend whether it’s safe to take these products with Kerendia.

Kerendia and vitamins or minerals

There are no specific reports of vitamins interacting with Kerendia. However, that does not mean vitamin interactions will not occur or be recognized in the future.

Kerendia may interact with potassium when you take this mineral as a supplement.* Multivitamins may also contain potassium. However, the amount of potassium in a multivitamin would usually be much less than in a potassium supplement.

Before you start treatment with Kerendia, tell your doctor and pharmacist which vitamins or minerals you take. They can advise whether it’s safe to take these products with Kerendia.

* To learn more about this interaction, see “Kerendia interactions with supplements” above.

Kerendia interactions with food

Grapefruit and grapefruit juice can interact with Kerendia. Specifically, grapefruit products can significantly slow the breakdown of Kerendia in your body. This could raise the level of Kerendia in your system, increasing your risk of side effects from the drug.* Due to this risk, your doctor may recommend avoiding grapefruit and grapefruit juice during Kerendia treatment.

Kerendia may interact with potassium when you take it as a supplement.† Certain foods may also be high in potassium. However, the quantity of potassium in foods is much lower than in a potassium supplement. Certain salt substitutes are also high in potassium. Using a potassium salt substitute while taking Kerendia can raise your risk of high potassium as a side effect. Your doctor may suggest avoiding or limiting potassium salt substitutes while taking Kerendia.

If you have additional questions or want more information about eating certain foods during Kerendia treatment, talk with your doctor.

* To learn about the side effects of Kerendia, see this article.
† To learn more about this interaction, see “Kerendia interactions with supplements” above.

Kerendia and vaccines

There are not any known interactions between Kerendia and vaccines. Talk with your doctor or pharmacist to see whether you are due for any vaccines.

Kerendia and lab tests

Kerendia is not known to interact with any lab tests. If you have concerns about this medication interacting with lab tests, talk with your doctor.

KERENDIA AND CANNABIS OR CBD

Cannabis (often called marijuana) and cannabis products, such as cannabidiol (CBD), have not been specifically reported to interact with Kerendia. However, as with any drug or supplement, talk with your doctor before using cannabis in combination with Kerendia. The impact of cannabis may affect how well you stick to your Kerendia treatment plan.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Certain medical conditions and other factors may increase the risk of interactions with Kerendia. Before you take this drug, be sure to talk with your doctor about your health history. Kerendia may not be the right treatment option if you have certain medical conditions or other factors affecting your health.

Health conditions or factors that might interact with Kerendia include:

• High blood potassium level. Kerendia may cause a high blood potassium level. Before you take Kerendia and during treatment, your doctor will check your potassium level with a blood test. Your doctor may temporarily delay or pause your treatment if tests show that your potassium level is high. They may continue Kerendia treatment once your potassium level returns to an acceptable range.
• Adrenal insufficiency. Doctors typically won’t prescribe Kerendia for people with adrenal insufficiency. To learn more about this interaction, see “When to avoid Kerendia” above.
• Liver condition. Doctors typically won’t prescribe Kerendia for people with a severe liver condition, such as liver failure. Talk with your doctor if you have a liver condition. They can decide whether it’s safe for you to take the drug.
• Allergic reaction. If you’ve had an allergic reaction to Kerendia or any of its ingredients, your doctor will likely not prescribe Kerendia. Taking the drug could cause another allergic reaction. You can ask them about other treatments that may be better choices for you.
• Breastfeeding. It’s not known whether Kerendia is safe to take while breastfeeding. There is not enough information to determine whether the drug passes into breast milk or what effects Kerendia may have on a child who is breastfed. If you’re breastfeeding or planning to, talk with your doctor before taking Kerendia. They’ll likely recommend that you avoid breastfeeding during Kerendia treatment and for at least 1 day after your last dose.
• Pregnancy. There have not been enough clinical trials to determine whether Kerendia is safe to take while pregnant. Animal studies show that the drug may cause congenital anomalies (commonly known as birth defects). However, it’s important to note that animal studies do not always indicate what may happen in humans. If you are pregnant or planning to become pregnant, tell your doctor before starting Kerendia. They can advise you on the right treatment plan for you.

You can take certain steps to help prevent interactions with Kerendia. Your doctor and pharmacist are key resources, so reach out to them before starting treatment. For example, you should plan to do the following:

• Let them know if you drink alcohol or use cannabis.
• Tell them about any other medications you take, as well as any supplements, herbs, and vitamins.
• Create a medication list, which your doctor and pharmacist can help you fill out.

It is also important to read the Kerendia label and other paperwork that may come with the drug. The label may have colored stickers that mention an interaction. And the paperwork, sometimes called the medication guide or patient package insert, may contain details about interactions.

If Kerendia does not come with paperwork, you can ask your pharmacist to print a copy. If you need help reading or understanding this information, ask your doctor or pharmacist.

You can also help prevent interactions with Kerendia by taking it exactly as your doctor prescribes.

Besides learning about interactions, you may want to find out more about Kerendia. These resources might help:

• Overview of Kerendia. For a general overview of Kerendia, you can see this article.
• Side effects. If you’re interested in the side effects of Kerendia, see this article. Another option is to refer to the Kerendia prescribing information.
• Dosage specifics. To learn about the dosage of Kerendia, see this article.
• Cost. If you’d like to learn about Kerendia and cost, see this article.
• Facts about your condition. To learn more about your condition, see our diabetes hub and list of kidney disease articles.

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.