Which common drugs require renal dose adjustment?

Key drugs: metformin (hold if eGFR < 30), DOACs (apixaban/rivaroxaban adjusted by eGFR and weight), antibiotics (penicillins, cephalosporins, aminoglycosides), NSAIDs (avoid if eGFR < 30), methotrexate (avoid if eGFR < 60).

How is creatinine clearance used for drug dosing?

Most drug package inserts use CrCl (Cockcroft-Gault) rather than eGFR (CKD-EPI) for dosing. Use actual body weight unless obese (use ideal body weight). Cockcroft-Gault: (140 minus age) x weight / (72 x Scr) x 0.85 (female).

At what eGFR is metformin contraindicated?

FDA 2016 guidance: metformin contraindicated when eGFR = 45. Reassess regularly as CKD progresses.

Renal Drug Dose Adjustment by GFR

Guide drug dose adjustments based on GFR categories (G1-G5). Covers common antibiotics, anticoagulants, antidiabetics, and analgesics requiring renal dose modification.

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Frequently Asked Questions

Which common drugs require renal dose adjustment?

How is creatinine clearance used for drug dosing?

At what eGFR is metformin contraindicated?