Firialta Dosage/Direction for Use

Prior to Initiation of Firialta: Measure serum potassium levels and estimated glomerular filtration rate (eGFR) before initiation. Do not initiate treatment if serum potassium is > 5.0 mEq/L [see Hyperkalemia under Precautions].
Recommended Starting Dosage: The recommended starting dose of Firialta is based on eGFR and is presented in Table 2. (See Table 2.)

Click on icon to see table/diagram/image

For patients who are unable to swallow whole tablets, Firialta may be crushed and mixed with water or soft foods such as applesauce immediately prior to use and administered orally [see PHARMACOLOGY: Pharmacokinetics under Actions].
Monitoring and Dose Adjustment: The target daily dose of Firialta is 20 mg.
Measure serum potassium 4 weeks after initiating treatment and adjust dose (see Table 3); if serum potassium levels are >4.8 to 5.0 mEq/L, initiation of Firialta treatment may be considered with additional serum potassium monitoring within the first 4 weeks based on clinical judgement and serum potassium levels [see Hyperkalemia under Precautions]. Monitor serum potassium 4 weeks after a dose adjustment and throughout treatment, and adjust the dose as needed (see Table 3) [see Hyperkalemia under Precautions and CYP3A4 Inhibitors and Inducers under Interactions]. (See Table 3.)

Click on icon to see table/diagram/image

Missed doses: Direct a patient to take a missed dose as soon as possible after it is noticed, but only on the same day. If this is not possible, the patient should skip the dose and continue with the next dose as prescribed.