Antimicrobial dosages for adults with impaired kidney function: D

This table gives dosing recommendations for adults with impaired kidney function. For antimicrobial dosing in children with impaired kidney function, seek expert advice.

Table 1. Antimicrobial dosages for adults with impaired kidney function: D
[NB1]
dapsone darunavir darunavir+cobicistat (Prezcobix) dicloxacillin	dolutegravir dolutegravir+abacavir+lamivudine (Triumeq) dolutegravir+rilpivirine (Juluca) doxycycline
dapsone
Dosage adjustment based on GFR [NB2] [NB3]
more than 50 mL/min	normal
10 to 50 mL/min	normal
less than 10 mL/min	50 to 100% 24-hourly
Dosages for dialysis
intermittent haemodialysis	as for GFR less than 10 mL/min; dose after dialysis
peritoneal dialysis	as for GFR less than 10 mL/min
continuous renal replacement therapy	as for GFR less than 10 mL/min
darunavir
Dosage adjustment based on GFR [NB2]
more than 50 mL/min	normal
10 to 50 mL/min	normal
less than 10 mL/min	normal
Dosages for dialysis [NB2]
intermittent haemodialysis	normal
peritoneal dialysis	normal
continuous renal replacement therapy	normal
darunavir+cobicistat (Prezcobix)
Dosage adjustment based on GFR [NB2]
more than 50 mL/min	normal
10 to 50 mL/min	normal
less than 10 mL/min	normal
Dosages for dialysis [NB2]
intermittent haemodialysis	normal
peritoneal dialysis	normal
continuous renal replacement therapy	normal
dicloxacillin
Dosage adjustment based on GFR [NB2] [NB3]
more than 50 mL/min	normal
10 to 50 mL/min	normal
less than 10 mL/min	100% 8-hourly
Dosages for dialysis [NB2]
intermittent haemodialysis	as for GFR less than 10 mL/min
peritoneal dialysis	as for GFR less than 10 mL/min
continuous renal replacement therapy	normal
dolutegravir
Dosage adjustment based on GFR [NB2]
more than 50 mL/min	normal
10 to 50 mL/min	normal
less than 10 mL/min	normal
Dosages for dialysis
intermittent haemodialysis	no data, see product information
peritoneal dialysis
continuous renal replacement therapy
dolutegravir+abacavir+lamivudine (Triumeq)
Dosage adjustment based on GFR [NB2]
more than 50 mL/min	normal
10 to 50 mL/min	avoid fixed-dose combination; see individual drugs
less than 10 mL/min	avoid fixed-dose combination; see individual drugs
Dosages for dialysis
intermittent haemodialysis	avoid fixed-dose combination; see individual drugs
peritoneal dialysis
continuous renal replacement therapy
dolutegravir+rilpivirine (Juluca)
Dosage adjustment based on GFR [NB2]
more than 50 mL/min	normal
10 to 50 mL/min	normal
less than 10 mL/min	normal
Dosages for dialysis
intermittent haemodialysis	no data, see product information
peritoneal dialysis
continuous renal replacement therapy
doxycycline
Dosage adjustment based on GFR [NB2]
more than 50 mL/min	normal
10 to 50 mL/min	normal
less than 10 mL/min	normal
Dosages for dialysis [NB2]
intermittent haemodialysis	normal
peritoneal dialysis	normal
continuous renal replacement therapy	normal
Note: GFR = glomerular filtration rate NB1: Dosing in patients with kidney impairment is complex. This table is intended as a guide only, see General considerations for antimicrobial dosage modification in kidney impairment. If relevant, see Dialysis and continuous renal replacement therapy for further guidance on using this table. NB2: ‘Normal’ indicates that the standard dosage regimen for the specific indication in these guidelines should be used. NB3: For multiple-daily doses, percentage dosage adjustments are calculated using the intermittent dose rather than the total daily dose (eg if standard dosing for drug X is 500 mg 6-hourly, then 50% at normal dosing interval = 250 mg 6-hourly, and 100% 12-hourly = 500 mg 12-hourly).