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Add once-daily Firialta to your patients’ current regimen1

01

INITIATION

10 mg if:

  • Serum potassium is ≤4.8 mmol/L, or >4.8 to 5.0 mmol/L with additional monitoring*

and

  • eGFR is ≥25 to <60 mL/min/1.73 m2

20 mg if:

  • Serum potassium is ≤4.8 mmol/L, or >4.8 to 5.0 mmol/L with additional monitoring*

and

  • eGFR is ≥60 mL/min/1.73 m2

02

CHECK LABS

Alt tag

Check serum potassium
and eGFR 4 weeks after:

  • initiation
  • restart
  • increase in dose

and routinely afterwards

03

TITRATION

Serum potassium
(mmol/L)
10 mg
20 mg
≤4.8
Increase to 20 mg if eGFR has not
decreased >30% compared with the
prior measurement
Maintain dose
>4.8 to 5.5
Maintain dose
>5.5
Withhold Firialta and restart at 10 mg when serum
potassium decreases to ≤5.0 mmol/L. Remeasure serum
potassium and eGFR 4 weeks after restart
Serum potassium
(mmol/L)
≤4.8
10 mg Increase to 20 mg if eGFR has not decreased >30% compared with the prior measurement

20 mg Maintain dose
>4.8 to 5.5
Maintain dose
>5.5
Withhold Firialta and restart at 10 mg when serum potassium decreases to ≤5.0 mmol/L. Remeasure serum potassium and eGFR 4 weeks after restart

*If serum potassium is >4.8 to 5.0 mmol/L, initiation of Firialta treatment may be considered with additional serum potassium monitoring within the first 4 weeks based on patient characteristics and serum potassium levels.1

 

  • Continue to routinely monitor serum potassium and eGFR, and titrate Firialta as needed
  • Patients can continue to take commonly prescribed medications including antidiabetic and antihypertensive therapies while on Firialta
  • Patients with eGFR ≥15 mL/min/1.73 m2 can continue Firialta treatment with dose adjustment based on serum potassium†
Potassium management2,3
  • There were no dietary restrictions regarding potassium for patients in the FIDELIO-DKD trial and the FIGARO-DKD trial
  • Potassium-lowering therapies (such as sodium polystyrene sulfonate, calcium polystyrene sulfonate, and potassium-binding agents) were allowed in both trials
Discover helpful resources for your patients
†Firialta should not be initiated in patients with eGFR <25 mL/min/1.73 m2.1

 

eGFR=estimated glomerular filtration rate.

References:

  • Firialta® Product Insert approved by NPRA 4th April 2024. Return to content
  • Bakris GL, et al; FIDELIO-DKD Investigators. N Engl J Med. 2020;383(23):2219-2229. Return to content
  • Pitt B, et al. N Engl J Med. 2021;385(24):2252-2263. doi:10.1056/NEJMoa2110956. Return to content

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