Renfit 20 mg Tablet

Non-steroidal mineralocorticoid receptor antagonist for:

• Chronic kidney disease with type 2 diabetes (with albuminuria) — slows kidney decline and reduces cardiovascular events
• Heart failure with mildly reduced or preserved ejection fraction (LVEF ≥ 40%)

CKD with type 2 diabetes: starting dose by kidney function:

• eGFR ≥ 60: 20 mg once daily
• eGFR 25–60: 10 mg once daily
• After 4 weeks, increase 10 mg to 20 mg if potassium ≤ 4.8 mmol/L and eGFR stable.
• Do not start if potassium > 5.0 mmol/L; withhold if > 5.5.

Heart failure: 10–20 mg once daily by eGFR, target 20–40 mg once daily.

• With or without food; tablets may be crushed.

• Use with strong CYP3A4 inhibitors (itraconazole, ketoconazole, clarithromycin, ritonavir)
• Addison's disease
• Allergy to finerenone

Very common: high potassium (hyperkalaemia).

Common: low blood pressure, low sodium, reduced eGFR (usually small, early), itching.

• Check potassium and eGFR before starting, at 4 weeks, after dose changes and regularly.
• Avoid potassium supplements and salt substitutes unless advised.
• Severe liver impairment: not recommended.

Avoid in pregnancy (animal harm); use contraception. Do not breastfeed.

• Strong CYP3A4 inhibitors (contraindicated); moderate/weak (e.g. erythromycin, verapamil, fluconazole) — monitor potassium
• Strong CYP3A4 inducers (rifampicin, carbamazepine, phenytoin, St John's wort) — avoid
• Potassium-sparing diuretics, spironolactone, eplerenone (avoid)
• ACE inhibitors/ARBs, trimethoprim (raise potassium — monitor)
• Grapefruit juice — avoid

High potassium likely; stop and seek medical care.

Store below 30°C.