What You Need to Know About Kerendia Side Effects

Every medication has potential side effects, and Kerendia (Finerenone) is no exception. The good news is that Kerendia was well-tolerated in large clinical trials, and most people take it without serious problems. But because it affects your potassium levels and blood pressure, there are specific things you should watch for.

This guide covers the common and serious side effects of Kerendia, who may be at higher risk, and exactly when you should call your doctor.

What Is Kerendia? A Quick Overview

Kerendia is a non-steroidal mineralocorticoid receptor antagonist (MRA) made by Bayer. It's FDA-approved 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 was also approved for certain types of heart failure (HFpEF/HFmrEF). For a deeper look, see our complete guide to Kerendia.

Common Side Effects

These side effects were reported in clinical trials and are the ones you're most likely to experience:

• Hyperkalemia (high potassium levels) — This is the most common side effect of Kerendia. Your body may retain more potassium than usual, which is why your doctor will monitor your potassium levels with regular blood tests. Mild hyperkalemia may not cause any noticeable symptoms.
• Hypotension (low blood pressure) — Some patients experience lower blood pressure than usual. This may cause dizziness, especially when standing up quickly.
• Hyponatremia (low sodium levels) — Less common, but Kerendia can lower your sodium levels.
• Dizziness or feeling faint — Often related to the blood pressure-lowering effect. This is usually mild and may improve as your body adjusts.

Most of these side effects are manageable and tend to be mild. Your doctor will schedule regular lab work — particularly potassium checks — to catch problems early before they become serious.

Serious Side Effects

While uncommon, these serious side effects require immediate medical attention:

• Severe hyperkalemia — If your potassium gets dangerously high, you may experience heart palpitations, irregular heartbeat, muscle weakness or paralysis, numbness, or tingling. This is a medical emergency. Call your doctor or go to the ER immediately.
• Severe hypotension — Signs include fainting, rapid breathing, and cold or clammy skin. If you feel like you might pass out or have trouble breathing, seek emergency care.
• Severe hyponatremia — Extremely low sodium can cause confusion and, in rare cases, seizures. If you experience sudden confusion or a seizure, call 911.

Important: Kerendia does not carry an FDA boxed warning, which means its safety profile is considered manageable with proper monitoring.

Who May Be at Higher Risk for Side Effects

Certain groups should be especially careful when taking Kerendia:

• Pregnant or breastfeeding women: Kerendia may cause fetal harm and is not recommended during pregnancy. Patients should not breastfeed during treatment and for 1 day after the final dose.
• Patients with adrenal insufficiency: Kerendia is contraindicated (should not be used) in patients with adrenal insufficiency.
• Patients with liver problems: Use with caution if you have hepatic (liver) impairment, as this can affect how your body processes the medication.
• Patients on potassium-raising medications: If you take ACE inhibitors, ARBs, potassium supplements, or potassium-sparing diuretics, your risk of hyperkalemia is higher. Your doctor should monitor your labs more closely. See our full list of Kerendia drug interactions.
• Patients with lower eGFR: Patients with more advanced kidney disease (lower eGFR) start at a lower dose (10 mg vs. 20 mg) to reduce risk.

How to Manage Side Effects

For Hyperkalemia

• Keep all scheduled lab appointments — your doctor will check potassium levels regularly, especially in the first few months.
• Avoid potassium-containing salt substitutes (like Nu-Salt or Morton Salt Substitute).
• Talk to your doctor before taking any potassium supplements or new medications.
• Follow any dietary guidance your doctor or dietitian provides about potassium-rich foods.

For Low Blood Pressure / Dizziness

• Stand up slowly from sitting or lying positions.
• Stay hydrated, but follow your doctor's fluid recommendations if you have heart failure or kidney disease.
• If dizziness is persistent, let your doctor know — they may need to adjust your dose or other blood pressure medications.

For Low Sodium

• Report symptoms like headache, nausea, or confusion to your doctor.
• Do not try to correct sodium levels on your own — your doctor will manage this with lab monitoring.

General Tips

• Take Kerendia at the same time every day as directed.
• Avoid grapefruit and grapefruit juice — they can increase Kerendia levels in your blood and raise the risk of side effects.
• Keep a list of all your medications and share it with every provider you see.
• Don't stop taking Kerendia without talking to your doctor first.

When to Call Your Doctor

Call your doctor or seek emergency care if you experience:

• Heart palpitations, irregular heartbeat, or chest pain
• Muscle weakness, numbness, or tingling
• Fainting or severe dizziness
• Confusion or disorientation
• Seizures
• Rapid breathing or cold, clammy skin

For non-urgent concerns like mild dizziness or general questions about your side effects, call your doctor's office during business hours. Don't wait for your next scheduled appointment if something feels off.

Final Thoughts

Kerendia's most important side effect — hyperkalemia — is well-understood and manageable with regular monitoring. Most patients tolerate the medication well, and the benefits of kidney and heart protection have been demonstrated in major clinical trials. The key is working closely with your doctor, keeping up with lab work, and knowing the warning signs.

If you're considering Kerendia or just starting it, make sure to read our guides on what Kerendia is and how to take it and how Kerendia works. And if you need help finding it in stock, Medfinder can help you locate a pharmacy near you.