Finerenone is a non-steroidal mineralocorticoid receptor antagonist (ns-MRA) that works by blocking the activity of mineralocorticoid receptors. Overactivation of these receptors can damage the kidneys, heart, and blood vessels. By inhibiting this pathway, finerenone exerts potent anti-inflammatory, anti-fibrotic, and antioxidant effects, conferring protection to the heart and kidneys.

The primary indication for finerenone is to treat adults with chronic kidney disease (CKD) associated with type 2 diabetes (T2D). It is used to reduce the risk of sustained decline in estimated glomerular filtration rate (eGFR), progression to end-stage kidney disease, and cardiovascular events such as non-fatal myocardial infarction and hospitalization for heart failure. Clinical trials like FIDELIO-DKD have established its efficacy in this patient population. Finerenone is administered as a once-daily oral tablet and represents a next-generation therapy for managing the cardiorenal risks in patients with diabetic kidney disease and other related conditions.