Can't fill your Kerendia prescription? Learn about alternatives like Spironolactone, Eplerenone, Farxiga, and Jardiance for kidney and heart protection.
If you've been prescribed Kerendia (Finerenone) but can't find it at your pharmacy — or the cost is too high — you may be wondering what other options are available. While Kerendia is a first-in-class medication with unique benefits, there are other drugs that can help protect your kidneys and heart.
In this article, we'll explain what Kerendia is, how it works, and walk you through several real alternatives you can discuss with your doctor. Important: Never switch or stop medications on your own. Always talk to your doctor before making any changes to your treatment.
Kerendia is the brand name for Finerenone, a non-steroidal mineralocorticoid receptor antagonist (MRA). It was approved by the FDA in July 2021 and is manufactured by Bayer. Kerendia is prescribed to reduce the risk of kidney function decline, kidney failure, cardiovascular death, heart attacks, and hospitalization for heart failure in adults with chronic kidney disease (CKD) associated with type 2 diabetes.
It is available as a tablet in 10 mg and 20 mg strengths, taken once daily. Without insurance, Kerendia costs between $670 and $950 per month. For a complete overview, visit our guide on what Kerendia is and how to take it.
Kerendia works by blocking mineralocorticoid receptors in your body. When these receptors are overactivated — which is common in people with CKD and diabetes — they trigger inflammation and fibrosis (scarring) in the kidneys and heart. By blocking these receptors, Kerendia helps slow kidney damage and reduces cardiovascular risk.
What makes Kerendia unique is that it's a non-steroidal MRA. Older MRAs like Spironolactone and Eplerenone are steroidal, which means they can cross-react with other hormone receptors and cause side effects like breast tenderness, sexual dysfunction, and hormonal imbalances. Kerendia is much more selective, resulting in fewer of these side effects. Learn more in our article on how Kerendia works.
Spironolactone is the oldest and most widely used mineralocorticoid receptor antagonist. It has been available as a generic for decades and is very affordable — typically costing $4 to $20 per month without insurance.
Spironolactone is FDA-approved for heart failure, hypertension, and edema (fluid retention). While it is not specifically approved for CKD associated with type 2 diabetes (the way Kerendia is), some doctors prescribe it off-label for kidney protection.
Key differences from Kerendia:
Eplerenone is another steroidal MRA, but it is more selective than Spironolactone. This means it causes fewer hormonal side effects. Eplerenone is available as a generic and typically costs $15 to $60 per month.
Eplerenone is FDA-approved for heart failure after a heart attack and for hypertension. Like Spironolactone, it is not specifically approved for CKD with diabetes, but it may be considered as an alternative in some cases.
Key differences from Kerendia:
Dapagliflozin, sold under the brand name Farxiga, is an SGLT2 inhibitor. While it works through a completely different mechanism than Kerendia, it has been shown to provide significant kidney and heart protection. Farxiga is FDA-approved for CKD (with or without diabetes), type 2 diabetes, and heart failure.
Many patients with CKD and diabetes actually take both Kerendia and an SGLT2 inhibitor like Farxiga, as they work through complementary pathways. However, if you can't access Kerendia, Farxiga alone still offers meaningful protection.
Key points about Farxiga:
Empagliflozin, sold as Jardiance, is another SGLT2 inhibitor with strong evidence for kidney and heart protection. It is FDA-approved for type 2 diabetes, heart failure, and CKD. Like Farxiga, Jardiance works differently from Kerendia but addresses some of the same risks.
Key points about Jardiance:
The best alternative to Kerendia depends on your specific medical situation. Here are some factors your doctor will consider:
Kerendia is a groundbreaking medication for people with CKD and type 2 diabetes, but it's not the only option available. If you can't fill your prescription due to availability or cost, talk to your doctor about alternatives like Spironolactone, Eplerenone, Farxiga, or Jardiance. Each has its own benefits and trade-offs.
If you'd like to keep trying to find Kerendia, use Medfinder to check which pharmacies near you have it in stock, or read our guide on how to find Kerendia in stock. And don't forget to explore savings options — our article on how to save money on Kerendia covers coupons, discount cards, and patient assistance programs that could bring the cost down significantly.
You focus on staying healthy. We'll handle the rest.
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