Finerenone tablets (KERENDIA, HF with LVEF >=40%)

Check potassium and eGFR before treatment; do not initiate if potassium >5.0 mEq/L. Start 20 mg daily at eGFR >=60 or 10 mg daily at 25 to <60; initiation below 25 is not recommended. For HF, target 40 mg daily when initiation eGFR is >=60, or 20 mg daily when it is 25 to <60.

Recheck potassium and eGFR four weeks after initiation or dose changes and periodically thereafter. Use the full HF-specific Table 3 before any increase, reduction, hold or restart; target doses are not automatic escalations. This selected summary does not reproduce every potassium/restart cell. Renal worsening can occur in HF. Do not apply the 40 mg HF target to the separate CKD-only regimen.

Recheck potassium/eGFR four weeks after initiation or a dose change, then periodically. Daily-dose actions by current potassium (mEq/L):

<5.0: 10 mg increases to 20 mg; 20 mg increases to 40 mg only if initiation eGFR >=60, otherwise remains 20 mg; 40 mg remains unchanged. If eGFR fell >30% from the previous measurement, maintain the current dose instead of increasing.

5.0 to <5.5: maintain current dose.

5.5 to <6.0: from 10 mg, withhold then restart 10 mg when potassium <5.5; from 20 mg reduce to 10 mg; from 40 mg reduce to 20 mg.

>=6.0: withhold; restart 10 mg when potassium <5.5. If repeated potassium measurements are >=5.5, restart 10 mg only when potassium <5.0.

Do not substitute the CKD potassium thresholds. Starting-dose eligibility, drug interactions and clinical deterioration still require the complete label.