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

Over the past decade, there have been significant advancements when it comes to managing chronic kidney disease (CKD). Notably, a few new medications have been FDA approved for people with the condition. These medications not only help prevent kidney function from worsening, but also lower the risk of life-threatening complications related to CKD.

Kerendia (finerenone) and Jardiance (empagliflozin) are two medications that can provide these benefits for certain people living with CKD. And they're both recommended by experts to help lower the risk of CKD complications.

But are Jardiance and Kerendia the same types of medications? The short answer is no. These medications work differently and have distinct uses. Below, we review five differences to keep in mind when comparing Kerendia versus Jardiance for CKD.

1. Kerendia and Jardiance have different FDA-approved uses

One main difference between Kerendia and Jardiance is their FDA-approved uses. This may be a main deciding factor for your prescriber when they're considering whether to recommend one over the other.

Kerendia is FDA approved to lower the risk of worsening kidney function, cardiovascular complications or death, and hospitalization for heart failure for adults living with CKD that's associated with Type 2 diabetes. Kerendia isn't approved for use in people who don't have Type 2 diabetes.

Jardiance has a few different FDA-approved uses. It's approved for:

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

• Lowering the risk of hospitalization and cardiovascular death for adults living with heart failure (whether or not they have diabetes)

• Lowering blood glucose (sugar) levels along with a diabetes-friendly diet and regular exercise in adults and children age 10 and older living with Type 2 diabetes

• Lowering the risk of cardiovascular death in adults living with Type 2 diabetes and heart disease

2. Kerendia and Jardiance work differently in the body

Kerendia and Jardiance work in different ways to manage CKD.

Kerendia is a nonsteroidal mineralocorticoid receptor antagonist (MRA). It works by blocking the activity of the hormone aldosterone in the kidneys, heart, and blood vessels. Some amount of aldosterone is necessary to help regulate blood pressure and sodium levels in the body. But some people with CKD have higher levels of aldosterone than people who don't have the condition.

High levels of aldosterone can cause inflammation and scarring of the kidneys, heart, and blood vessels. Over time, this can damage these parts of the body. By blocking aldosterone's activity, Kerendia can help prevent or slow aldosterone's harmful effects.

Jardiance is a sodium-glucose cotransporter-2 (SGLT2) inhibitor. It primarily works by blocking the protein SGLT2 in the kidneys. This helps remove excess glucose and sodium from the bloodstream. Less sodium, in particular, helps take strain off the kidneys and heart.

Experts believe Jardiance helps protect the kidneys in other ways, too. These include lowering blood pressure, helping the kidneys to work more efficiently, and preventing kidney inflammation and scarring.

3. Kerendia and Jardiance have different typical dosages

Both Kerendia and Jardiance are available as oral tablets. But there are differences in how the medications are taken.

The target Kerendia dosage for most people is 20 mg by mouth once a day. 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. But for consistent effects, you should take your dose at about the same time each day.

The typical Jardiance dosage for CKD is 10 mg by mouth once a day. You should take your doses in the morning. As we'll discuss more below, Jardiance can cause you to pee more in the hours after you take it. So taking it in the morning can help you avoid waking up throughout the night to use the bathroom.

There aren't any recommended dosage adjustments if you're only taking Jardiance for CKD. If you also have Type 2 diabetes, your prescriber may raise your dosage to 25 mg once a day if the lower dosage isn't keeping your glucose levels in your target range.

Good to know: If you have trouble swallowing pills, you can crush Kerendia tablets and mix them with water or soft foods like applesauce right before taking your doses. You shouldn't cut, chew, or crush Jardiance tablets.

4. Kerendia and Jardiance have different side effects

Potential side effects are another difference to consider when comparing Kerendia and Jardiance. Common and mild side effects for each medication are listed in the table below.

While raised potassium levels (hyperkalemia) with Kerendia is common, it can become harmful or even dangerous in some cases. If your potassium is too high, you may experience symptoms such as muscle weakness, nausea or vomiting, or fatigue. In severe cases, potentially life-threatening arrhythmias (irregular heartbeats) can also occur. Because of this, you'll need to go for routine blood work to make sure your potassium levels are staying within a safe range.

Jardiance also has a few serious side effects to know about. In severe cases, Jardiance may cause dehydration because of increased urination. The medication can also cause hypoglycemia (low blood glucose) and, in very rare cases, ketoacidosis (too much acid in the blood). Life-threatening infections are also possible, but very rare.

Certain health conditions and interacting medications may raise your risk of serious side effects related to Kerendia or Jardiance. This is not a comprehensive list of all the possible side effects for either medication. Your prescriber can help weigh the pros and cons of each to determine which might be right for you.

5. Kerendia and Jardiance have different potential interactions

Potential drug interactions can be a major factor when it comes to choosing between Kerendia and Jardiance. These two medications have unique sets of potential interactions.

Many of Kerendia's interactions raise the risk of experiencing high potassium levels. 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 losartan (Cozaar)

• Some antibiotics, such as ciprofloxacin (Cipro) and erythromycin (Ery-Tab)

• 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)

Many of Jardiance's interactions raise the risk of dehydration or hypoglycemia. Notable Jardiance interactions can be caused by:

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

• Insulin

• Sulfonylureas, such as glipizide (Glucotrol XL) and glyburide (Glynase, DiaBeta)

• Meglitinides ("glinides"), such as repaglinide

• Lithium (Lithobid)

In many cases, Kerendia and Jardiance interactions can be managed with dosage changes. Be sure to share an updated medication list with your prescriber and pharmacist when starting treatment with either Kerendia or Jardiance. They can use this list to identify and manage potential interactions.

Can you take Kerendia and Jardiance together?

Yes, you can safely combine Kerendia and Jardiance if needed. In fact, there's evidence that taking both, along with an ACE inhibitor or an ARB, may help lower your risk of serious CKD complications more than taking just one or two of these medications. So it's possible that your prescriber may recommend taking both Kerendia and Jardiance.

How to save on Kerendia and Jardiance

There are ways to save on Kerendia and Jardiance, which are only available as brand-name medications. GoodRx can help you navigate between patient assistance programs and copay savings cards:

• Save with a copay savings card. If you have commercial insurance, you may be eligible to pay as little as $10 per prescription for Jardiance or as little as $0 per month for Kerendia 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 Jardiance's patient assistance program, which offer the medications free of cost.