Kerendia vs. Farxiga: 5 Differences Between These Kidney Disease Medications

Chronic kidney disease (CKD) is a common health condition, especially among people living with Type 2 diabetes. Over time, CKD can raise the risk of cardiovascular complications, such as heart failure. For some people with CKD, medications to help lower the risk of these complications are recommended.

Kerendia (finerenone) and Farxiga (dapagliflozin) are two medications that are FDA approved to help lower the risk of complications caused by CKD. While both are expert-recommended treatments, they work differently. Below, we review five differences to consider when comparing Kerendia versus Farxiga for CKD.

1. Kerendia and Farxiga have different FDA-approved uses

Kerendia and Farxiga are FDA approved for different uses. This may be a main deciding factor for your prescriber when they’re considering whether to recommend one over the other.

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Kerendia is FDA approved for adults living with CKD that’s associated with Type 2 diabetes. More specifically, it’s approved to lower the risk of CKD complications. These complications include worsening kidney function, cardiovascular complications, and hospitalizations due to heart failure. Kerendia isn’t approved to treat CKD in people who don’t have diabetes.

Farxiga has more FDA-approved uses than Kerendia. It’s approved for:

• Lowering the risk of worsening kidney function, hospitalizations for heart failure, and cardiovascular death for adults living with CKD (whether or not they have diabetes)

• Lowering the risk of urgent care visits, hospitalizations, and death due to heart failure in adults living with chronic heart failure (whether or not they have diabetes)

• Reducing blood glucose (sugar) when combined with a diabetes-friendly diet and regular exercise in adults and children 10 years or older who are living with Type 2 diabetes

• Lowering the risk of hospitalizations for heart failure in adults living with Type 2 diabetes who are at risk for developing or already have heart disease

2. Kerendia and Farxiga work differently in the body

Another difference between Kerendia and Farxiga is how they work in the body.

Kerendia is a nonsteroidal mineralocorticoid receptor antagonist (MRA). It blocks the actions of a hormone in the body called aldosterone. This hormone helps balance blood pressure. But high levels can damage the kidneys, heart, and blood vessels over time. By blocking aldosterone, Kerendia can help prevent future damage.

Farxiga is a sodium-glucose cotransporter-2 (SGLT2) inhibitor. It works by blocking the activity of the protein SGLT2 in the kidneys. This causes the body to get rid of excess sodium and glucose through urine, which helps take strain off the kidneys and heart.

EXPERT PICKS: WHAT TO READ NEXT

• More about Kerendia: Our GoodRx-perts review what you should know about Kerendia, including how it works.

• When is the best time to take Farxiga? Read pharmacist-backed tips for taking Farxiga, so you can get the most out of your medication.

• Drinks that impact kidney health: Learn about the best beverages to drink if you have kidney disease — plus, drinks you should avoid.

Farxiga likely helps protect the kidneys in other ways, too. Experts believe that the medication lowers blood pressure, helps the kidneys work more efficiently, and prevents kidney damage and scarring.

3. Kerendia and Farxiga have different typical dosages

Both Kerendia and Farxiga are oral tablets that you take once a day. But there are slight differences in how they’re taken.

Most people taking Kerendia end up taking 20 mg once a day as their maintenance (steady) dosage. But your dosage may be lower than that depending on your kidney function and blood potassium levels. You can take Kerendia at any time of day. Just be sure to take it at about the same time each day.

The typical Farxiga dosage for CKD is 10 mg once a day. There are no recommended dosage adjustments for people taking it for this reason. It’s best to take Farxiga in the morning. Because of how it works, it’s common to have to pee more than usual after taking it. Taking Farxiga in the morning can help you avoid waking up throughout the night to use the bathroom.

Good to know: You can crush Kerendia tablets and mix them with a small amount of water or a soft food like applesauce. This can be helpful if you have trouble swallowing pills. Farxiga tablets shouldn’t be cut, chewed, or crushed.

4. Kerendia and Farxiga have different side effects

The Kerendia and Farxiga have unique potential side effects. But both are generally well tolerated. The common side effects for each are detailed in the table below.

Both medications can also cause rare but serious side effects. It’s common for Kerendia to raise potassium levels (hyperkalemia). But in rare cases, potassium levels can become dangerously high. This can cause symptoms such as muscle weakness, nausea or vomiting, and irregular heartbeats. Because of this, you’ll need to go for routine blood work to make sure your potassium levels are staying within a safe range.

Farxiga can cause dehydration and low blood glucose. And in very rare cases, it can also cause serious genital infections and ketoacidosis (too much acid in the blood). Certain health conditions and interacting medications can raise the risk of these serious side effects.

This isn’t a full list of side effects for either Kerendia or Farxiga. Be sure to discuss potential side effects with your prescriber before starting either medication.

5. Kerendia and Farxiga have different potential interactions

Your prescriber will also consider drug interactions before recommending either Kerendia or Farxiga. The two medications interact with different substances.

Notable Kerendia interactions can be caused by:

• Grapefruit juice

• St. John’s wort (an herbal supplement)

• Amiodarone (Pacerone)

• Medications that raise potassium levels, such as spironolactone (Aldactone)

• Angiotensin-converting enzyme (ACE) inhibitors, such as lisinopril (Zestril, Qbrelis)

• Angiotensin II receptor blockers (ARBs), such as valsartan (Diovan)

• Some antibiotics, such as ciprofloxacin (Cipro) and clarithromycin

• Medications that contain ritonavir (Norvir), such as Paxlovid (nirmatrelvir / ritonavir)

• Certain calcium channel blockers, such as diltiazem (Cardizem) and verapamil

• Certain seizure medications, such as carbamazepine and phenytoin (Dilantin, Phenytek)

Farxiga can interact with:

• Insulin

• Sulfonylureas, such as glyburide (Glynase, DiaBeta)

• Glinides, such as repaglinide

• Diuretics (water pills), such as hydrochlorothiazide (Microzide) and furosemide (Lasix)

• Lithium (Lithobid)

This isn’t a comprehensive list of possible interactions for either Kerendia or Farxiga. So be sure to share an updated medication list with your prescriber and pharmacist. They can check it more thoroughly for potential interactions.

Can you take Farxiga and Kerendia together?

Yes, you can take Farxiga and Kerendia together if needed. This can be more beneficial than taking just one in some cases. There’s also evidence that suggests combining Kerendia, Farxiga, and an ACE inhibitor or an ARB may help lower the risk of CKD complications more than taking just one or two of these medications.

How to save on Kerendia and Farxiga

There are ways to save on Kerendia and Farxiga, which are both available as brand-name medications. (Farxiga is also available as a lower-cost generic medication.) GoodRx can help you navigate your options, which include using patient assistance programs and copay savings cards:

• Save with GoodRx. GoodRx may be able to help you save over 50% off the average retail price of the generic version of Farxiga. Generic dapagliflozin’s price at certain pharmacies may be as low as $332.55 with a free GoodRx coupon.

• Save with a copay savings card. If you have commercial insurance, you may be eligible to pay as little as $0 per month for Kerendia or Farxiga using a savings card from the manufacturer.

• Save with a patient assistance program. If you’re uninsured or underinsured, you may be eligible for Kerendia’s or Farxiga’s patient assistance program. These programs offer the medications free of cost.

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Written by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

Reviewed by:

Ferras Bashqoy, PharmD, BCCCP, BCPPS

Ferras Bashqoy, PharmD, BCCCP, BCPPS, is a clinical pharmacotherapy specialist in the Neonatal Intensive Care Unit (NICU) at Hassenfeld Children’s Hospital in New York City. His favorite part of the job is working with preterm newborns because they are strong and mighty despite their size.

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