Drug Doses in Renal Failure

Dose GFR > 50 GFR 1050 GFR < 10

Drug HD CAPD CRRT
Method (mL/min) (mL/min) (mL/min)
Acarbose D 100% Avoid Avoid Unknown Unknown Avoid
Acebutolol D 100% 50% 3050% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Acetaminophen I q4h q6h q8h Dose as GFR < 10 Dose as GFR < 10 As normal GFR
Acetazolamide I q6h q12h Avoid No data No data Avoid
Acetohexamide I Avoid Avoid Avoid Avoid Avoid Avoid
Acetohydroxamic Acid D 100% 100% Avoid Unknown Unknown Unknown
Acetylsalicyclic Acid I q4h q46h Avoid As normal GFR As normal GFR As normal GFR
Dose post HD
Acrivastine D 8 mg q12h 8 mg q1224h 8 mg q24h Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Aciclovir D, I 5 mg/kg q8h 5 mg/kg q1224h 2.5 mg/kg q24h Dose as GFR < 10 Dose as GFR < 10 3.5 mg/kg/day
Dose post HD
Adenosine D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Albuterol D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Alfentanil D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Allopurinol D 75% 50% 33% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Alprazolam D 100% 100% 100% Unknown Unknown NA
Alteplase (t-PA) 100% 100% 100% As normal GFR As normal GFR As normal GFR
Altretamine D Unknown Unknown Unknown No data No data Unknown
Amantadine I q2448h q4872h q7d Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Amikacin D, I 6090% q12h 3070% q1218h 2030% q2448h 5 mg/kg post HD 1520 mg/L/day Dose as GFR 1050
Amiloride D 100% 50% Avoid NA NA NA
Aminophylline D 100% 200400 mg q12h 200300 mg q12h Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Amiodarone D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Amitriptyline D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Amlodipine D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Amoxapine D 100% 100% 100% Unknown Unknown NA
Amoxicillin I q8h q812h q24h Dose as GFR < 10 250 mg q8h As normal GFR
Dose post HD
Amphotericin I q24h q24h q2436h Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Amphotericin B Colloidal I q24h q24h q2436h Dose as GFR < 10 Dose as GFR < 10 Dose for GFR 1050
Amphotericin B lipid I q24h q24h q2436h Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Ampicillin I q6h q612h q1224h Dose as GFR < 10 Dose as GFR < 10 Dose as G FR 1050
Dose post HD
Amrinone D 100% 100% 5075% No data No data Dose as GFR 1050

Internal Medicine / HD 2011 Page 1

 Dose GFR > 50 GFR 1050 GFR < 10
Drug HD CAPD CRRT
Method (mL/min) (mL/min) (mL/min)
Astemizole D 100% 100% 100% Unknown Unknown NA
Atenolol D, I 100% q24h 100% q24h 50% q24h Dose as GFR < 10 Dose as GFR < 10 As normal GFR
Atovaquone 100% 100% 100% As normal GFR As normal GFR As normal GFR
Atracurium D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Auranofin D 36 mg q24h 3 mg q24h Avoid Avoid Avoid Dose as GFR 1050
Azathioprine D 100% 75% 50% As normal GFR Dose as GFR < 10 Dose as GFR 1050
Azithromycin D 100% 100% 100% No data No data No data
Azlocillin I q46h q68h q8h Dose as GFR < 10 Dose for GFR < 10 Dose as GFR 1050
Dose post HD
Aztreonam D 100% 5075% 25% Dose as GFR < 10 Dose for GFR < 10 Dose as GFR 1050
Dose post HD
Basiliximab 100% 100% 100% As normal GFR As normal GFR As normal GFR
Benazepril D 100% 5075% 2550% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Betamethasone D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Betaxolol D 100% 100% 50% Dose as GFR < 10 Dose as GFR < 10 As normal GFR
Bezafibrate D 70% 50% q2448h Avoid 200 mg q72h 200 mg q72h Dose as GFR 1050
Bisoprolol D 100% 100% 50% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Bleomycin D 100% 75% 50% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Bopindolol D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Bretylium D 100% 2550% 25% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Bromocriptine D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Brompheniramine D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Budesonide D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Bumetanide D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Bupropion D 100% q24h 100% q24h 100% q24h Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Buspirone D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 As normal GFR
50%ifanuric 50%ifanuric
Busulfan D 100% 100% 100% Unknown Unknown Dose as GFR 1050
Butorphanol D 100% 75% 50% Unknown Unknown NA
Capreomycin I q24h q24h q48h Dose as GFR < 10 Dose as GFR < 10 As normal GFR
Captopril D, I 100% q812h 75% q1218h 50% q24h Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Carbamazepine D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Carbidopa D 100% 100% 100% Unknown Unknown Unknown
Carboplatin D 100% 50% 25% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Carmustine D 100% 100% 100% As normal GFR As normal GFR As normal GFR

Internal Medicine / HD 2011 Page 2

 Dose GFR > 50 GFR 1050 GFR < 10
Drug HD CAPD CRRT
Method (mL/min) (mL/min) (mL/min)
Carvedilol D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Cefaclor D 100% 50100% 50% 250500 mg q8h 250 mg q812h As normal GFR
Cefadroxil I q12h q1224h q2448h 0.51.0 g post HD 0.5 g/day As normal GFR
Cefamandole I q6h q68h q12h 0.51.0 g q12h 0.51.0 g q12h Dose as GFR 1050
Dose post HD
Cefazolin I q8h q12h q2448h 0.51.0 g post HD 0.5 g q12h Dose as GFR 1050
Cefepime I q12h q1624h q2448h 1.0 g post HD Dose for GFR < 10 Not recommended
Cefixime D 100% 75% 50% 200 mg q24h 200 mg q24h Dose as GFR 1050
Dose post HD
Cefmenoxime D, I 1.0 g q8h 0.75 g q8h 0.75 g q12h 0.75 g q12h 0.75 g q12h Dose as GFR 1050
Dose post HD
Cefmetazole I q16h q24h q48h Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Dose post HD
Cefonicid D, I 0.5 g/d 0.1 g0.5 g/day 0.1 g/day Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Ceforanide I q12h q1224h q2448h 0.51.0 g post HD None 1.0 g/day
Cefotaxime I 100% q8h 100% q8h 50% q812h Dose as GFR < 10 1 g q24h 1 g q12h
Dose post HD
Cefotetan D 100% 50% 25% 250500 mg q24h 1 g q24h 750 mg q12h
+500 mg post HD
Cefoxitin I 100% 12 g q824h 0.51 g q1224h 0.51 g q2448h 1 g q24h Dose as GFR 1050
+1 g post HD
Cefpodoxime I 100% 100% 100200 mg Dose as GFR < 10 Dose as GFR < 10 As normal GFR
q2448h
Cefprozil D, I 100% 50% q24h 50% q24h Dose as GFR < 10 Dose as GFR < 10 Dose as GFR < 10
Dose post HD
Ceftazidime I 100% 0.51 g q1224h 0.51 g q48h 1 g post HD 0.51 g q24h 0.51 g q12h
Ceftibuten D 100% 50% 25% 400 mg post HD Dose as GFR < 10 Dose as GFR 1050
Ceftizoxime I 0.51.5 g q8h 0.251 g q12h 0.250.5 g q24h 0.250.5 g q24h 0.51.0 g q24h Dose as GFR 1050
Dose post HD
Ceftriaxone D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Dose post HD
Cefuroxime axetil (oral) D 100% 100% 250 mg q24h Dose as GFR < 10 Dose as GFR < 10 As normal GFR
Dose post HD
Cefuroxime (iv) 100% 0.751.5 g q812h 750 mg q12h 750 mg q24h 750 mg q24h Dose as GFR 1050
Dose post HD

Internal Medicine / HD 2011 Page 3

 Dose GFR > 50 GFR 1050 GFR < 10
Drug HD CAPD CRRT
Method (mL/min) (mL/min) (mL/min)
Cephalexin I 250500 mg q6h 250500 mg q812h 250500 mg Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
q1224h Dose post HD
Cephalothin I q6h q68h q12h Dose as GFR < 10 Dose as GFR < 10 1 g q8h
Dose post HD
Cephapirin I q6h q68h q12h Dose as GFR < 10 Dose as GFR < 10 1 g q8h
Dose post HD
Cephradine D 100% 50% 25% Dose as GFR < 10 Dose for GFR < 10 As normal GFR
Dose post dialysis
Cetirizine D 100% 100% 50% Dose as GFR < 10 Dose as GFR < 10 As normal GFR
Chloralhydrate D 100% Avoid Avoid Avoid Avoid Avoid
Chlorambucil D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Chloramphenicol D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Chlorazepate D 100% 100% 100% Unknown Unknown NA
Chlordiazepoxide D 100% 100% 50% Dose as GFR < 10 Dose as GFR < 10 As normal GFR
Chloroquine D 100% 100% 50% Dose as GFR < 10 Dose as GFR < 10 As normal GFR
Chlorpheniramine D 100% 100% 50% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Chlorpromazine D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Chlorpropamide D 50% Avoid Avoid Avoid Avoid Avoid
Chlorthalidone I 100% 100% Avoid Avoid Avoid NA
Cholestyramine D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Cibenzoline D, I 100% q12h 100% q12h 66% q24h Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Cidofovir D 50100% Avoid Avoid No data No data Avoid
Cilastin D 100% 50% Avoid Avoid Avoid Avoid
Cilazapril D, I 75% q24h 50% q2448h 1025% q72h Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Cimetidine D 100% 50% 25% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Cinoxacin D 100% 50% Avoid Avoid Avoid Avoid
Ciprofloxacin D 100% 5075% 50% 250 mg q12h 250 mg q8h 200 mg IV q12h
Cisapride D 100% 50% 50% Dose as GFR < 10 Dose as GFR < 10 50100%
Cisplatin D 100% 75% 50% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Cladribine D Unknown Unknown Unknown Unknown Unknown Unknown
Clarithromycin D 100% 75% 5075% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Dose post HD
Clavulanic acid D 100% 100% 5075% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Dose post HD
Clindamycin D 100% 100% 100% As normal GFR As normal GFR As normal GFR

Internal Medicine / HD 2011 Page 4

 Dose GFR > 50 GFR 1050 GFR < 10
Drug HD CAPD CRRT
Method (mL/min) (mL/min) (mL/min)
Clofazimine 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 No data
Clofibrate I q612h q1218h Avoid Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Clomipramine D 100% Start at lower dose and monitor effect Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Clonazepam D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Clonidine D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Codeine D 100% 75% 50% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Colchicine D 100% 100% 50% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Colestipol D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Cortisone D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Cyclophosphamide D 100% 75100% 5075% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Cycloserine I q12h q1224h q24h Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Cyclosporine D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Cytarabine D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Dapsone 100% 100% 50% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Daunorubicin D 100% 75% 50% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Delavirdine 100% 100% 100% Dose as GFR < 10 No data Dose as GFR 1050
Desferrioxamine D 100% 100% 50% Unknown Unknown Dose as GFR 1050
Desipramine D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 NA
Dexamethasone D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Diazepam D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Diazoxide D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Diclofenac D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Dicloxacillin D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 NA
Didanosine I 100% 50% 25% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Diflunisal D 100% 50% 50% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Digitoxin D 100% 100% 5075% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Digoxin D, I 100% q24h 2575% q36h 1025% q48h Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Dilevalol D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Unknown
Diltiazem D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Diphenhydramine D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Dipyridamole D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Dirithromycin 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Disopyramide I q8h q12h q2440h Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Dobutamine D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Doxacurium D 100% 50% 50% Unknown Unknown Dose as GFR 1050

Internal Medicine / HD 2011 Page 5

 Dose GFR > 50 GFR 1050 GFR < 10
Drug HD CAPD CRRT
Method (mL/min) (mL/min) (mL/min)
Doxepin D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Doxorubicin D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Doxycycline D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Dyphylline D 75% 50% 25% dose Unknown Dose as GFR 1050
Ebastine D 100% 50% 50% Unknown Unknown Dose as GFR 1050
Enalapril D 100% 75100% 50% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Epirubicin D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Erythromycin D 100% 100% 5075% Dose as GFR < 10 Dose as GFR < 10 As normal GFR
Estazolam D 100% 100% 100% Unknown Unknown NA
Etanercept 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Ethambutol I q24h q2436h q48h Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Dose post HD
Ethchlorvynol D 100% Avoid Avoid Dose as GFR < 10 Dose as GFR < 10 NA
Ethionamide D 100% 100% 50% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Ethosuximide D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Etodolac D 100% 100% 100% As normal GFR As normal GFR Dose as GFR 1050
Etomidate D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Etoposide D 100% 75% 50% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Famciclovir I 100% q1248h 50% q48h Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Dose post HD
Famotidine D 100% 50% 20 mg q24h Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Fazadinium D 100% 100% 100% Unknown Unknown Dose as GFR 1050
Felodipine D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Fenoprofen D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Fentanyl D 100% 75% 50% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Fexofenadine I q12h q1224h q24h Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Flecainide D 100% 75% 50% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Fleroxacin D 100% 50% 50% 400 mg post HD 400 mg/24h Dose as GFR 1050
Fluconazole D 100% 100% 50% Dose as GFR < 10 Dose as GFR < 10 As normal GFR
Dose post HD
Flucytosine I q12h q16h q24h Dose as GFR < 10 0.5/24h Dose as GFR 1050
Dose post HD
Fludarabine D 100% 75% 50% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Flumazenil D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Flunarizine D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050

Internal Medicine / HD 2011 Page 6

 Dose GFR > 50 GFR 1050 GFR < 10
Drug HD CAPD CRRT
Method (mL/min) (mL/min) (mL/min)
Dose post HD
Fluoxetine D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Flurazepam D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Flurbiprofen D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Flutamide D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Fluvastatin D 100% 100% 50% Dose as GFR < 10 Dose as GFR < 10 As normal GFR
Fluvoxamine D 100% 100% 100% Dose as GFR < 10 Unknown NA
Foscarnet D 28 mg/kg/q8h 15 mg/kg/q8h 6 mg/kg/q8h Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Dose post HD
Fosinopril D 100% 100% 75100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Furosemide D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Gabapentin D, I 400 mg q8h 300 mg q1224h 300 mg q48h 300 mg load then Dose as GFR < 10 Dose as GFR 1050
200 mg post HD
Gallamine D 75% Avoid Avoid NA NA Dose as GFR 1050
Ganciclovir I 2.55 mg/kg q12h 1.252.5 mg/kg q24h 1.25 mg/kg q24h Dose as GFR < 10 Dose as GFR < 10 2.5 mg/kg q24h
Dose post HD
Gemfibrozil D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Gentamicin D, I 6090% q812h 3070% q12h 2030% q2472h Dose as GFR < 10 34 mg/L/day Dose as GFR 1050
Dose post HD
Glibornuride D Unknown Unknown Unknown Unknown Unknown Avoid
Gliclazide D 100% 2040 mg/day 2040 mg/day Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Glipizide D 100% 100% Contraindicated Dose as GFR < 10 Dose as GFR < 10 Avoid
Glyburide D Unknown Avoid Avoid Avoid Avoid Avoid
Gold Sodium Thiomalate D 50% Avoid Avoid Dose as GFR < 10 Dose as GFR < 10 Avoid
Griseofulvin D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Guanabenz D 100% 100% 100% Unknown Unknown Dose as GFR 1050
Guanadrel I q12h q1224h q2448h Unknown Unknown Dose as GFR 1050
Guanethidine I q24h q24h q2436h Unknown Unknown Avoid
Guanfacine D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Haloperidol D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Heparin D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Hexobarbital D 100% 100% 100% Dose as GFR < 10 Unknown NA
Hydralazine I q8h q8h q816h Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Hydrocortisone D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Hydroxyurea D 100% 50% 20% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050

Internal Medicine / HD 2011 Page 7

 Dose GFR > 50 GFR 1050 GFR < 10
Drug HD CAPD CRRT
Method (mL/min) (mL/min) (mL/min)
Ibuprofen D 100% 100% 100% As normal GFR As normal GFR Dose as GFR 1050
Idarubicin Unknown Unknown Unknown Unknown Unknown Unknown
Ifosfamide D 100% 75% 50% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Iloprost D 100% 100% 50% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Imipenem D 100% 50% 25% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Dose post HD
Imipramine D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Indapamide D 100% 100% 50% Dose as GFR < 10 Dose as GFR < 10 NA
Indinavir 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Indobufen D 100% 50% 25% Unknown Unknown NA
Indomethacin D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Infliximab 100% No data No data No data No data No data
Insulin (soluble) D Variable Variable Variable Variable Variable Variable
Ipratropium D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Isoniazid D 100% 100% 75% Dose as GFR < 10 Dose as GFR < 10 As normal GFR
Dose post HD
Isosorbide D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Dose post HD
Isradipine D 100% 100% 100 As normal GFR As normal GFR As normal GFR
Itraconazole D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Kanamycin D, I 6090% q812h 3070% q12h 2030% q2448h normaldose 1520 mg/L/day Dose as GFR 1050
Ketamine D 100% 100% 100% Unknown Unknown Dose as GFR 1050
Ketanserin D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Ketoconazole D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Ketoprofen D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Ketorolac D 100% 50% 50% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Labetolol D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Lamivudine D, I 100% 50150 mg qd 25 mg qd Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Dose post HD
Lamotrigine D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Lansoprazole D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Lepirudin 0.4 mg/kg bolus 50% bolus Avoid Dose as GFR < 10 Dose as GFR < 10 50% bolus
0.15 mg/kg/h 1530% 15%
Levodopa D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Levofloxacin D 100% 50% 2550% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050

Internal Medicine / HD 2011 Page 8

 Dose GFR > 50 GFR 1050 GFR < 10
Drug HD CAPD CRRT
Method (mL/min) (mL/min) (mL/min)
Lincomycin I q6h q612h q1224h Dose as GFR < 10 Dose as GFR < 10 NA
Linezolid D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Caution
Lisinopril D 100% 5075% 2550% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Lispro Insulin D Variable Variable Variable Variable Variable Variable
Lithium carbonate D 100% 5075% 2550% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Dose post HD
Lomefloxacin D 100% 5075% 50% Dose as GFR < 10 Dose as GFR < 10 NA
Loracarbef I q12h q24h q35d Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Dose post HD
Lorazepam D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Losartan D 100% 100% 100% titrate titrate Dose as GFR 1050
Lovastatin D 100% 100% 100% Unknown Unknown Dose for GFR
LMW Heparin D 100% Prophylactic dose only only Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Maprotiline D 100% 100% 100% Unknown Unknown NA
Meclofenamic acid D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Mefenamic acid D 100% 100% 50% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Mefloquine 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Melphalan D 100% 75% 50% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Meperidine D 100% 75% 50% Avoid Avoid Avoid
Meprobamate I q6h q912h q1218h Dose as GFR < 10 Dose as GFR < 10 NA
Meropenem D, I 500 mg q6h 250500 mg q12h 250500 mg q24h Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Dose post HD
Metaproterenol D 100% 100% 100% Unknown Unknown Dose as GFR 1050
Metformin D 50% Avoid Avoid Avoid Avoid Avoid
Methadone D 100% 100% 5075% Dose as GFR < 10 Dose as GFR < 10 As normal GFR
Methenamine Mandelate D 100% Avoid Avoid NA NA NA
Methicillin I q46h q68h q812h Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Methimazole D 100% 100% 100% Unknown Unknown Dose as GFR 1050
Methotrexate D 100% 50% Contraindicated Contraindicated Contraindicated Dose as GFR 1050
Methyldopa I q8h q812h q1224h Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Dose post HD
Methylprednisolone D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Dose post HD
Metoclopramide D 100% 75% 50% Dose as GFR < 10 Dose as GFR < 10 5075%

Internal Medicine / HD 2011 Page 9

 Dose GFR > 50 GFR 1050 GFR < 10
Drug HD CAPD CRRT
Method (mL/min) (mL/min) (mL/min)
Metolazone D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Metoprolol D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Metronidazole D 100% q812h 100% q812h 100% q12h As normal GFR Dose as GFR < 10 As normal GFR
Dose post HD
Mexiletine D 100% 100% 5075% Dose as GFR < 10 Dose as GFR < 10 As normal GFR
Mezlocillin I q46h q68h q8h Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Miconazole D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Midazolam D 100% 100% 50% Dose as GFR < 10 Dose as GFR < 10 As normal GFR
Midodrine 510 mg q8h 510 mg q8h 2.510 mg q8h Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Miglitol D 50% Avoid Avoid Unknown Unknown Avoid
Milrinone D 100% 100% 50 to 75% No data No data Dose as GFR 1050
Minocycline D 100% 100% 100% None None Dose as GFR 1050
Minoxidil D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Mitomycin C D 100% 100% 75% Dose as GFR < 10 Dose as GFR < 10 As normal GFR
Mitoxantrone D 100% 100% 100% Unknown Unknown Dose as GFR 1050
Mivacurium D 100% 50% 50% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Moricizine D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Morphine D 100% 75% 50% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Moxalactam I q812h q1224h q2448h Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Dose post HD
Mycophenolate mofetil D 100% 50100% 50100% Dose as GFR < 10 Dose as GFR < 10 As normal GFR
Nabumetone D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
N-Acetylcysteine D 100% 100% 75% Dose as GFR < 10 Dose as GFR < 10 100%
Nadolol D 100% 50% 25% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Dose post HD
Nafcillin D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Nalidixic acid D 100% Avoid Avoid Avoid Avoid Avoid
Naloxone D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Naproxen D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Nefazodone D 100% 100% 100% Unknown Unknown NA
Nefopam D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Nelfinavir No data No data No data No data No data No data
Neostigmine D 100% 50% 25% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Netilmicin D, I 5090% q812h 2060% q24h 10% q24h 2 mg/kg post each IV: 2 mg/kg q48h Dose as GFR 1050
HD session IP: 7.510 mg/LPE

Internal Medicine / HD 2011 Page 10

 Dose GFR > 50 GFR 1050 GFR < 10
Drug HD CAPD CRRT
Method (mL/min) (mL/min) (mL/min)
Nicardipine D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Nicotinic acid D 100% 50% 25% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Nifedipine D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Nimodipine D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Nisoldipine D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Nitrazepam D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 As normal GFR
Nitrofurantoin D Avoid Contraindicated Contraindicated Contraindicated Contraindicated Contraindicated
Nitroglycerine D 100% 100% 100% No data No data Dose as GFR 1050
Nitroprusside D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Nitrosoureas D 100% 75% 2550% Dose as GFR < 10 Unknown Unknown
Nizatidine D 75% 50% 25% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Norfloxacin I q12h q1224h Avoid NA NA NA
Nortriptyline D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Ofloxacin D 100% 50% 25% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Omeprazole D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Ondansetron D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Orphenadrine D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Oxaprozin D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Oxatomide D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 NA
Oxazepam D 100% 100% 75% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Oxcarbazepine D 100% 100% 100% Unknown Unknown Unknown
Paclitaxel D 100% 100% 100% As normal GFR As normal GFR Dose as GFR 1050
Pancuronium D 100% 50% Avoid Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Paroxetine D 100% 5075% 50% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
(PAS) D 100% 5075% 50% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Dose after dialysis
Penbutolol D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Penicillamine D 100% Avoid Avoid weekly post HD Avoid Avoid
Penicillin G D 100% 75% 2050% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Penicillin VK D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 NA
Dose post HD
Pentamidine I q24h q2436h q48h Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Pentazocine D 100% 75% 50% Dose as GFR < 10 Unknown Dose as GFR 1050
Pentobarbital D 100% 100% 100% Dose as GFR < 10 Unknown Dose as GFR 1050
Pentopril D 100% 5075% 50% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050

Internal Medicine / HD 2011 Page 11

 Dose GFR > 50 GFR 1050 GFR < 10
Drug HD CAPD CRRT
Method (mL/min) (mL/min) (mL/min)
Pefloxacin D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Perindopril D 100% 75% 50% 2550% Unknown Dose as GFR 1050
Phenelzine D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Phenobarbital I q812h q812h q1216h Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Phenylbutazone D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Phenytoin D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Pindolol D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Pioglitazone D 100% 100% 100% with caution caution caution caution
Pipecuronium D 100% 50% 25% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Piperacillin I q46h q68h q8h Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Dose post HD
Piretanide D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 NA
Piroxicam D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Plicamycin D 100% 75% 50% Unknown Unknown Unknown
Pravastatin D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Prazepam D 100% 100% 100% Unknown Unknown NA
Prazosin D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Prednisolone D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Dose post HD
Prednisone D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Pregabalin D 100% q812h 50% q812h 25% q24h Dose as GFR < 10 Dose as GFR < 10 No data
Extra dose post HD
Primaquine 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Primidone I q8h q812h q1224h dose Unknown Unknown
Probenecid D 100% Avoid Avoid Avoid Avoid Avoid
Probucol D 100% 100% 100% Unknown Unknown Dose as GFR 1050
Procainamide I q4h q612h Avoid Avoid Avoid Avoid
Promethazine D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Propafenone D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Propofol D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Propoxyphene D 100% 100% Avoid Avoid Avoid NA
Propranolol D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Propylthiouracil D 100% 75% 50% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Protryptyline D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 NA
Pyrazinimide D 100% As normal GFR As normal GFR As normal GFR As normal GFR As normal GFR

Internal Medicine / HD 2011 Page 12

 Dose GFR > 50 GFR 1050 GFR < 10
Drug HD CAPD CRRT
Method (mL/min) (mL/min) (mL/min)
Pyrimethamine D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Quazepam D Unknown Unknown Unknown Unknown Unknown NA
Quinapril D 100% 75100% 50% Dose as GFR 1050 Dose as GFR < 10 Dose as GFR 1050
Quinidine D 100% 100% 100% Dose as GFR < 10 As normal GFR As normal GFR
Quinine I q8h q812h q24h Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Dose post HD
Ramipril D 100% 5075% 2550% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Ranitidine D 100% 100% 50% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Ribavirin D 100% 100% 50% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Dose post HD
Rifabutin 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Rifampin D 100% 50100% 50100% Dose as GFR < 10 Dose as GFR < 10 As normal GFR
Ritonavir 100% 100% 100% As normal GFR As normal GFR As normal GFR
Rituximab 100% caution caution caution caution caution
Rosiglitazone D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Saquinavir 100% 100% 100% As normal GFR As normal GFR As normal GFR
Secobarbital D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 NA
Sertraline D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Simvastatin D 100% 100% 10 mg q24h Dose as GFR < 10 Dose as GFR < 10 As normal GFR
Sodium valproate D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Sotalol D 100% 2550% Avoid Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Sparfloxacin D, I 100% 5075% 50% q48h Dose as GFR < 10 No data Dose as GFR 1050
Spectinomycin D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Spironolactone I q612h q1224h Avoid Dose as GFR < 10 Dose as GFR < 10 Avoid
Stavudine D, I 100% 50% q1224h 50% q24h Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Dose post HD
Streptokinase D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Streptomycin I q24h q2472h q7296h 750 mg 23/week 2040 mg/L/day Dose as GFR 1050
Streptozotocin D 100% 75% 50% Unknown Unknown Unknown
Succinylcholine D 100% 100% 100% Unknown Unknown Dose as GFR 1050
Sufentanil D 100% 100% 100% Unknown Unknown Dose as GFR 1050
Sulbactam I q68h q1224h q2448h Dose as GFR < 10 0.751.5 g/day 750 mg q12h
Dose post HD
Sulfamethoxazole I q12h q18h q24h 1 g after dialysis 1 g/day Dose as GFR 1050
Sulfinpyrazone D 100% 100% Avoid None None Dose as GFR 1050

Internal Medicine / HD 2011 Page 13

 Dose GFR > 50 GFR 1050 GFR < 10
Drug HD CAPD CRRT
Method (mL/min) (mL/min) (mL/min)
Sulindac D 100% 50100% 50100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Sulotroban D 50% 30% 10% Unknown Unknown Unknown
Tacrolimus 100% 100% 100% As normal GFR As normal GFR As normal GFR
Tamoxifen D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Tazobactam D 100% 75% 50% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Teicoplanin I q24h q4872h q72h Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Temazepam D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Teniposide D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Terazosin D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Terbutaline D 100% 50% Avoid Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Terfenadine D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Tetracycline I q812h q1224h q24h Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Thiazides D 100% 100% Avoid Dose as GFR < 10 Dose as GFR < 10 NA
Thiopental D 100% 100% 75% NA NA NA
Ticarcillin D, I 12 g q4h 12 g q8h 12 g q12h 3 g after dialysis Dose as GFR < 10 Dose as GFR 1050
Ticlopidine D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Tigecycline 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Timolol D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Tobramycin D, I 6090% q812h 3070% q12h 2030% q2448h normaldose 34 mg/L/day Dose as GFR 1050
Tolazamide D 100% 100% 100% Unknown Unknown Avoid
Tolbutamide D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Avoid
Tolmetin D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Topiramate D 100% 50% 25% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Topotecan D 75% 50% 25% No data No data No data
Torsemide D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 NA
Tramadol D 100% 50100 mg q612h 50 mg q12h Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Tranexamic acid D 50% 25% 10% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Tranylcypromine D Unknown Unknown Unknown Unknown Unknown NA
Trazodone D 100% 100% Avoid/50% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Triamcinolone D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Triamterene I q12h q12h Avoid Avoid Avoid Avoid
Triazolam D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 NA
Trihexyphenidyl D Unknown Unknown Unknown Unknown Unknown Unknown
Trimethadione I q8h q812h q1224h Unknown Unknown Dose as GFR 1050
Trimethoprim I q12h 50% q18h 50% q24h Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050

Internal Medicine / HD 2011 Page 14

 Dose GFR > 50 GFR 1050 GFR < 10
Drug HD CAPD CRRT
Method (mL/min) (mL/min) (mL/min)
Trimetrexate D 100% 50100% Avoid No data No data No data
Trimipramine D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 NA
Tripelennamine D Unknown Unknown Unknown Unknown Unknown NA
Triprolidine D Unknown Unknown Unknown Unknown Unknown NA
Tubocurarine D 75% 50% Avoid Unknown Unknown Dose as GFR 1050
Urokinase D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Valganciclovir D 50100% 450 mg q2448h 450 mg BiW Avoid Avoid 450 mg q48h
Vancomycin D, I 500 mg q612h 500 mg q1248h 500 mg q4896h Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Vecuronium D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Venlafaxine D 100% 50% 50% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Verapamil D 100% 100% 100% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Vidarabine D 100% 100% 75% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Infuse post HD
Vigabatrin D 100% 50% 25% Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Vinblastine D 100% 100% 100% 100% 23/week As normal GFR As normal GFR
Dose post HD
Vincristine D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Vinorelbine D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Warfarin D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Zafirlukast D 100% 100% 100% As normal GFR As normal GFR As normal GFR
Zalcitabine I 100% q12h q24h Dose as GFR < 10 No data Dose as GFR 1050
Dose post HD
Zidovudine (AZT) D, I 100% q8h 100% q8h 50% q12h Dose as GFR < 10 Dose as GFR < 10 Dose as GFR 1050
Zileuton 100% 100% 100% Dose as GFR < 10 Unknown Dose as GFR 1050
CAPD, chronic ambulatory peritoneal dialysis; CRRT, continuous renal replacement therapies; HD, hemodialysis; GFR, glomerular filtration rate; D, decreasing individual
doses; I, increasing individual doses; NA, not applicable

Internal Medicine / HD 2011 Page 15