Clinical Guidelines for the use of Palliative Care Drugs in Renal ...

SUGGESTED FIRST LINE DRUGS IN RENAL FAILURE
• The suggestions below only apply when renal failure is the main factor in deciding
which drug (in a given class) to use.
• The reasons for suggesting these drugs may include:
1. Clearance (and therefore dosing) is relatively unaffected by renal impairment;
2. The drug’s mechanism of action has specific benefit in renal impairment
and/or
3. The drug is relatively less nephrotoxic (NB not important once a patient
becomes anuric)
• There will be occasions where other considerations become more important than
renal failure. For example, a particular drug may be preferable because of a
beneficial side effect profile, even though it would require significant dose
adjustment. In such circumstances, please refer to the alphabetical list of drugs
(pages 11-22) for prescribing advice.
• It should be remembered that the central nervous system effects of any drug can
be increased in renal failure, even if drug clearance is not affected.
ANTICOAGULANTS
For GFR