People with diabetes have a higher risk of many different health issues, including kidney and heart problems. Although various medicines can help reduce the risk of these issues, many people with diabetes may still get chronic kidney disease (CKD). People who have diabetes and CKD have a higher risk of serious health issues. A medicine called Kerendia, which was approved in 2021, may help reduce these risks in some people.
How Does Kerendia Work for People With Diabetes and Chronic Kidney Disease?
Over time, the high blood sugar levels in people with type 2 diabetes can damage organs in the body. Many people with diabetes will develop damage to their kidneys. Damaged kidneys do not work as well as they should, leading to a condition called chronic kidney disease (CKD). This condition can get worse with time, eventually leading to serious loss of kidney function and even kidney failure.
High blood sugar levels may also damage the heart and blood vessels (cardiovascular disease). This increases a person’s risk of serious cardiovascular issues, such as a stroke, heart attack, and heart failure. People with CKD are more likely to develop heart issues because kidneys that do not function correctly place more stress on the heart. People with diabetes who also have CKD and cardiovascular issues are at a higher risk of dying from these conditions.
The key to treating diabetes and related health issues is to control blood sugar levels. If a person has high blood pressure, they should also take medicines to help control their blood pressure. Keeping blood sugar levels and blood pressure in check can help to limit damage to the heart, blood vessels, and kidneys, which helps to reduce the risk of serious health issues and even death. Many people who have diabetes and CKD will also take a medicine that helps to protect their kidneys from further damage.
Kerendia has a unique way of helping to slow down damage to the heart and kidneys. The active ingredient, finerenone, blocks the mineralocorticoid receptor (MR), which is found in the kidneys, heart, and blood vessels. This receptor can be too active in people with diabetes. By blocking MR, Kerendia helps the kidneys remove sodium from the blood. It can also help to reduce swelling (inflammation) and the buildup of scar tissue (fibrosis) in the heart and blood vessels. Over time, this may help to reduce the risk of serious health issues.
How Do I Use It?
Kerendia is a tablet that is taken by mouth once every day, with or without food. If you are not able to swallow the tablet whole, you can crush the tablet and mix it with water or a soft food like pudding or applesauce. After it is crushed and mixed, it should be taken right away.
Once you have started taking Kerendia, your health care provider will monitor your potassium levels on a regular basis. It is important that you keep all of your appointments to have your blood levels checked. Depending on your levels, your health care provider may tell you to increase or decrease your dose, or to stop taking the medicine completely for a few days.
If you miss a dose of Kerendia, take it as soon as you remember, as long as it is still the same day as the missed dose. If it is already the next day, do not take your missed dose. Taking double or extra doses of this medicine can increase your risk of side effects.
How Was It Studied?
Two studies were done to see if Kerendia was safe and effective for adults with type 2 diabetes and CKD. The people in these studies were at least 18 years old, with an average age of about 64 years. Most (70%) were male and most (68%) were White. About 22% were Asian and 4% were Black; the race of the other people in these studies was not reported.
Here is some other important information about the people in these studies:
- Everyone had type 2 diabetes and CKD.
- Some people had been diagnosed with heart failure, but no one was having current symptoms of heart failure. Some people had already had a stroke or heart attack, but these occurred more than a month before the study started.
- Everyone in the studies was taking a medicine to protect their kidneys. Almost every person (97%) was using medicines for high blood sugar. About half (51%) were taking a type of medicine called a diuretic (also known as a water pill). If someone was taking any of these medicines before the study started, they were told to continue taking them during the study.
- Kerendia was compared with a placebo (a dummy medicine that has no effect). No one knew if they were receiving the medicine or the placebo.
One of these studies measured how well the drug worked by counting the number of serious kidney issues that happened during the study and how long it took for these things to happen. This included the number of people who:
- Had their kidney disease get much worse
- Had kidney failure
- Died from a kidney problem
The other study measured how well the drug worked by counting the number of serious cardiovascular (heart or blood vessel-related) events that happened during the study and how long it took for these things to happen. This included the number of people who:
- Had a stroke or heart attack
- Were hospitalized for heart failure
- Died from a heart problem
What Were the Benefits Seen in These Studies?
Kidney problems. During 2.5 years in the study, fewer people who took Kerendia had serious kidney problems than the people who took a placebo. Although some people who took Kerendia still had serious kidney problems, they didn’t happen as often as they did in the people who took a placebo. This means that, for some people, Kerendia helped to prevent certain issues from happening, such as kidney function getting much worse, kidney failure, or death from a kidney problem.
Heart problems. During 3.5 years in the study, fewer people who took Kerendia had serious heart problems than the people who took a placebo. Although some people who took Kerendia still had serious heart events, these events didn’t happen as often as they did in the people who took a placebo. This means that, for some people, Kerendia helped to prevent a stroke, a heart attack, hospitalization for heart failure, or death from a heart problem.
How Quickly Will Kerendia Work for CKD?
Even if Kerendia is working, you may not be able to tell. Over time, the drug may slow down the damage to your heart, blood vessels, or kidneys, making you less likely to have a serious heart or kidney problem. Studies show that as you keep taking the medicine, your risk should continue to decrease from where it would be if you were not taking the medicine. But these studies only lasted 4 years. It is not yet clear how much your risk will change after more than 4 years of taking the medicine.
Since Kerendia works by slowing the damage to your heart and kidneys, it is important to keep taking it even if you can’t tell that it is working. It is also important not to stop taking any of your other diabetes, heart, or kidney medicines. If you are concerned about any of your medicines and whether they are working for you, speak with your health care provider before making any changes.
How Can I Prevent or Manage Side Effects?
Kerendia may cause high potassium levels in some people. Your health care provider will monitor your potassium levels while you are taking this medicine and may adjust your dose if needed. It is important that you do not take any potassium supplements without speaking to your health care provider first. You should also avoid using salt substitutes in your diet, since these products often contain large amounts of potassium. If you have a history of high potassium levels, let your health care provider know before starting this medicine.
These are not all of the possible side effects. Talk with your health care provider if you are having symptoms that bother you. If you experience anything that you think may be caused by Kerendia, you can also report side effects to the FDA at 800-FDA-1088 (800-332-1088).
Are There Any Interactions With Other Medicines?
There are many medicines that can alter the blood levels of Kerendia. Some of these medicines may increase the side effects from Kerendia while others may reduce these effects. In certain cases, these effects are so significant that these medicines should not be taken together.
Kerendia can cause high potassium levels in some people. A condition called adrenal insufficiency and other medicines can also have this effect. Taking Kerendia if you have adrenal insufficiency or along with any of these other medicines may increase your risk of having high potassium levels.
It is important for your health care provider to be aware of every medicine you are taking. Tell your pharmacist or health care provider about all the prescription or over-the-counter medicines, vitamins/minerals, herbal products, or other supplements you take or have recently taken. This will help them come up with the best treatment plan for you.
Are There Any Interactions With Foods or Drinks?
It is important not to eat grapefruit or drink grapefruit juice while you are using Kerendia. Grapefruit increases the levels of Kerendia in the body, which can increase the risk of side effects. This interaction will happen even if grapefruit is consumed at a different time of day than the medicine, so it is important to avoid grapefruit completely.
Is There a Coupon Card Available?
There is a savings coupon available from the drugmaker that may allow you to pay as little as $0 for your prescription. Whether you are eligible depends on whether you have prescription insurance, and what type of insurance you have. You can find out more at https://www.kerendia-us.com/savings-and-support.