Medications for IgA Nephropathy

Several kinds of medicine are used to treat IgA nephropathy. They work in different ways, but they share the same goals: lower the protein in your urine, control your blood pressure, and slow damage to your kidneys. Most people take more than one, and your plan may change over time.^1-4

Blood pressure medicines (ACE inhibitors and ARBs)

ACE inhibitors and ARBs are the long-standing foundation of IgA nephropathy treatment. They lower blood pressure and reduce the amount of protein leaking into your urine, which helps protect your kidneys. Many people stay on one of these even after starting newer drugs.^1,3,4

SGLT2 inhibitors

Originally developed to lower blood sugar in type 2 diabetes, SGLT2 inhibitors are now used to protect the kidneys. They lower urine protein and help slow kidney disease, and they are often added alongside an ACE inhibitor or ARB.⁴

Newer FDA-approved drugs for IgA nephropathy

The US Food and Drug Administration (FDA) has approved several drugs developed specifically for IgA nephropathy. Each targets a different part of the disease:^5,6

• Corticosteroids – A targeted-release corticosteroid, budesonide (Tarpeyo®), lowers the immune activity behind IgA nephropathy.
• Endothelin receptor antagonists – Sparsentan (Filspari®) and atrasentan (Vanrafia®) lower pressure in the kidney filters and reduce urine protein.
• Complement inhibitors – Iptacopan (Fabhalta®) blocks part of the immune system called the complement system.

Medicines that calm the immune system

Because IgA nephropathy is an autoimmune disease, doctors sometimes use medicines that calm the immune system, such as corticosteroids, for people at higher risk of their disease getting worse. These can have significant side effects and should be used carefully.^1,3

How your doctor chooses

There is no single right combination for everyone. Your doctor considers how much protein is in your urine, how well your kidneys are working, the extent of damage in your kidneys, your other health conditions, and your preferences. Some medicines are FDA-approved specifically for IgA nephropathy, while others are approved for related problems like high blood pressure and used as part of kidney care.^4,5

Taking your medicines safely

Most people with IgA nephropathy take more than 1 medicine, so a few habits help:^1,4

• Take each medicine exactly as prescribed, and at the same time each day when you can.
• Keep an up-to-date list of everything you take, including over-the-counter drugs, vitamins, and supplements, and share it with your care team.
• Report side effects to your doctor rather than stopping a medicine on your own.

Other things to know

Some treatments listed here are not approved by the FDA to treat IgA nephropathy. They may be approved for other conditions, such as high blood pressure. A doctor may prescribe them “off-label” when evidence suggests they help. Talk to your doctor about what is right for you.

Talk to your doctor

Never start, stop, or change a medicine without talking to your care team. Ask what each medicine does, what side effects to watch for, and how it fits with your other treatments. Working closely with your doctor is the best way to get the most from your medications while staying safe.^3,4