Drug Interaction Report

Finerenone and Cilostazol: Interaction Details

A pharmacist-reviewed analysis of the Finerenone and Cilostazol interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Cilostazol

Pletal®
+

Finerenone

Kerendia Kerendia®
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Dr. Brian Staiger, PharmD, BCPS
Updated Aug 8, 2026
Editorial policy · Data sources
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Interaction severity
Major
Potentially serious — often needs a change or close monitoring.
How we grade severity & evidence

Severity levels

  • Contraindicated: These should generally not be used together.
  • Major: Potentially serious — often needs a change or close monitoring.
  • Moderate: Can be significant — usually manageable with monitoring.
  • Minor: Usually limited clinical impact.

Evidence grades

  • Established: Well documented — supported by controlled studies or strong clinical data.
  • Probable: Good supporting evidence, though not definitively proven.
  • Suspected: Some evidence suggests this interaction, but it is not well established.
  • Possible: Limited or conflicting evidence; the interaction may occur.
  • Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.

Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.

Of 218 documented Finerenone interactions, 180 are rated major — including this one.
Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.
Onset
unspecified
Evidence
probable
Severity
Major

What happens

Increased finerenone exposure and an increased risk of finerenone-related adverse effects

Interaction Deep Dive

Concomitant use of finerenone with a moderate or weak CYP3A4 inhibitor may increase the risk of finerenone adverse reactions. If used concomitantly, monitor serum potassium during drug initiation or dosage adjustment of either finerenone or the moderate or weak CYP3A4 inhibitor, and adjust finerenone dosage as appropriate. Concomitant use of finerenone, a CYP3A4 substrate, with erythromycin, a moderate CYP3A4 inhibitor, increased finerenone mean AUC by 248% and mean Cmax by 88%, respectively. Concomitant use of verapamil (moderate CYP3A4 inhibitor) increased finerenone mean AUC and Cmax by 170% and 122%, respectively. Concomitant use of finerenone with amiodarone, a weak CYP3A4 inhibitor, increased finerenone AUC by 21%1.

Why it happens (mechanism)

Inhibition of CYP3A4-mediated metabolism of finerenone

Literature reports

1 report — tap to read

a) Concomitant use of erythromycin (moderate CYP3A4 inhibitor) increased finerenone mean AUC and Cmax by 248% and 88%, respectively. Concomitant use of verapamil (moderate CYP3A4 inhibitor) increased finerenone mean AUC and Cmax by 170% and 122%, respectively. Concomitant use of amiodarone (weak CYP3A4 inhibitor) increased finerenone AUC by 21% 1.

Common questions

Can I take Finerenone and Cilostazol together?

Increased finerenone exposure and an increased risk of finerenone-related adverse effects Always confirm with your pharmacist or prescriber before making any change.

How serious is the Finerenone and Cilostazol interaction?

It is rated major. Potentially serious — often needs a change or close monitoring.

How quickly could this interaction happen?

The documented onset is "unspecified". The timing of this interaction is not well characterized.

How strong is the evidence for this interaction?

The evidence is graded "probable". Good supporting evidence, though not definitively proven.

Questions for your pharmacist

  • Does my dose of Finerenone or Cilostazol need adjusting while I take them together?
  • What symptoms should prompt me to call you or my prescriber right away?
  • Does the timing of my doses matter for this combination?
  • Is there a safer alternative to one of these medications for me?

References (1)

  1. Product Information: KERENDIA(R) oral tablets, finerenone oral tablets. Bayer HealthCare Pharmaceuticals Inc (per FDA), Whippany, NJ, 2025. DailyMed
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Cilostazol

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Finerenone

Keep reading about Finerenone

All Finerenone interactions (218) Finerenone drug information
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Beyond drug–drug

These medications also interact with supplements

Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:

Cilostazol + Activated Charcoal Danshen Grapefruit Piracetam St. John's Wort Acacia Rigidula Aconite Adrafinil + 278 more
Finerenone + Activated Charcoal Grapefruit St. John's Wort Acacia Rigidula Adrafinil African Wild Potato American Elder Astaxanthin + 138 more

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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.