Drug dosage in patients with renal disease

Abstract

Patients with renal impairment excrete drugs more slowly than normal individuals. Ta avoid the increased risk of toxicity as the consequence of drug accumulation tollowing repeated administration of the “usual” dose, the dosage regimen has to be modified in aceordanee with the lower speed of drug elimination. A simple graphie method is deseribed to estimate the individual overall elimination rate constant of a drug trom the ereatinine clearanee of the patient with renal disease. Based on the estimated elimination rate eonstant, the individual dosage regimen is ealculated according to pharmaeokinetie principles. As a result, two simple dosage rules tor intermittent and for eontinuous administration of drugs to patients with renal impairment are reeommended. For special circumstanees, two more sophistieated dosage rules are given.