5 Kerendia Side Effects, and How to Manage Them

High blood glucose (sugar) from Type 2 diabetes can cause damage to your kidneys. This damage makes it harder for your kidneys to function. Over time, this can lead to chronic kidney disease (CKD), where your kidneys stop working as well as they should. Thankfully, there is a medication available to protect your kidney health.

Kerendia (finerenone) is a prescription medication that’s FDA-approved to treat CKD, specifically in adults with Type 2 diabetes. It’s a mineralocorticoid receptor antagonist (MRA) that works by blocking a hormone called aldosterone.

High levels of aldosterone can cause inflammation in your kidneys, blood vessels, and heart. In fact, people with CKD tend to have too much aldosterone in their body compared with people without kidney problems. But, aldosterone also plays a role in balancing your electrolytes and blood pressure. Kerendia side effects can occur because of this.

Kerendia side effects at a glance

Here’s a summary of the side effects reported during Kerendia’s initial clinical trials. But keep in mind that other side effects may occur, too. Be sure to speak with your prescriber about any side effects you’re concerned about while taking Kerendia.

Common Kerendia side effects include:

• High potassium levels

• Low blood pressure

• Low sodium levels

• High uric acid levels

• Changes in results from estimated glomerular filtration rate (eGFR), a kidney function test

Below, we’ll review these five Kerendia side effects and how to manage them.

1. High potassium

High blood levels of potassium (hyperkalemia) was the most common Kerendia side effect in clinical trials. This is because Kerendia can prevent potassium loss through your urine. 

Mild cases of hyperkalemia usually don’t cause any symptoms. But it’s important to be aware of possible signs of it. Symptoms of high potassium can include: 

• Muscle weakness

• Confusion

• Tingling

• Numbness

• Nausea and vomiting

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Very high potassium levels can cause more life-threatening symptoms, such as irregular heartbeat, chest pain, or shortness of breath. If you’re experiencing any of these serious side effects, seek medical attention right away.

Managing hyperkalemia from Kerendia

It’s recommended to have blood tests to check your potassium levels (and eGFR) before starting Kerendia and regularly while you’re taking it. These will help your prescriber catch high potassium levels before they become dangerous. If your potassium levels are too high, your prescriber may change your Kerendia dose or have you stop taking it.

In addition to these blood tests, you may be asked to avoid taking potassium supplements or eating high quantities of potassium-rich foods, such as avocados. Furthermore, certain medications, such as lisinopril (Zestril), can also cause high potassium levels. 

Be sure to speak with your prescriber about your current medication list, diet, and any supplements you are taking. They can tell you if any adjustments are necessary, large or small.

2. Low blood pressure

Kerendia can cause very low blood pressure, also known as hypotension. This happens because Kerendia can make you pee more fluids, which lowers your blood volume.

Symptoms of low blood pressure can include:

• Blurry vision

• Dizziness

• Confusion

• Lightheadedness

• Tiredness

• Nausea

Speak with your prescriber if you experience any of these symptoms of low blood pressure. But if you’re feeling very faint, have someone take you to the nearest ER right away.

Fortunately, in clinical trials, most people's blood pressure normalized after taking Kerendia for about 1 month. Still, be sure to check your blood pressure regularly at home, and let your prescriber know if you’re taking any blood pressure-lowering medications. 

3. Low sodium

As mentioned above, aldosterone normally balances electrolytes in your body — including sodium. By blocking aldosterone, Kerendia can cause sodium loss through your urine. This may result in low blood sodium levels (hyponatremia).

Symptoms of low sodium may include:

• Dizziness

• Headache

• Weakness

• Nausea and vomiting

• Muscle cramps or spasms

• Loss of appetite

As with your potassium levels, your prescriber will likely recommend regular blood tests to check your sodium levels. If your sodium level is low, your prescriber may recommend changing your diet or limiting how much water you drink.

However, if your levels are at risk of dropping too low, your prescriber may recommend taking a sodium supplement, changing your dose of Kerendia, or stopping it altogether. That’s because very low sodium levels can cause dangerous symptoms, such as hallucinations, confusion, and seizures.

4. Higher uric acid levels

Kerendia can cause higher levels of uric acid (hyperuricemia) in your blood. Uric acid is a waste product that your body makes when it breaks down purines found in food and drinks. High uric acid levels can lead to a condition called gout, where you have pain and swelling in your joints.

The risk of high uric acid is greater when you start taking Kerendia. But it usually goes down as you keep taking it.

Luckily, most people who developed high uric acid levels in Kerendia’s clinical trials did not have any symptoms. But, if you have a history of gout, it’s important to speak with your prescriber before starting Kerendia. They can help you monitor your uric acid and lower your risk of gout flare-ups.

5. Kidney lab work changes

Your prescriber should check your kidney function (eGFR) before starting you on Kerendia. Kidney function tests help your prescriber choose the right starting dose for you and make sure it’s safe for you to take.

After you start taking Kerendia, though, you might notice lower kidney function results within the first 4 weeks of beginning the prescription. This change is usually temporary and typically stabilizes as your body adjusts to the medication. 

Does Kerendia make you pee more?

Yes. Kerendia can make you pee more. This is because Kerendia is an MRA that blocks aldosterone. Aldosterone manages the balance of water and salt in your body. By blocking aldosterone, Kerendia helps your body get rid of extra water through your urine.

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Written by:

Sheila McAdoo, PharmD

Sheila McAdoo, PharmD, is a licensed pharmacist in Virginia, New York, and the District of Columbia. She has worked in the pharmacy industry for 12 years and currently works as a community pharmacist.

Edited by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

Reviewed by:

Jennifer Gershman, PharmD, CPh, PACS

Jennifer Gershman, PharmD, is a licensed pharmacist in Florida. She has worked in the pharmacy industry for more than 15 years and is currently a medical writer.

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