Approved Formulary
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Renal Dose Adjustments
| Per policy, these drugs are subject to renal dosing adjustments by pharmacy. | |||
|---|---|---|---|
| A | Generic + Route (Brand) • Indications |
Usual Adult Dose Comments |
Renal Dosage Adjustments |
| acyclovir IV (Zovirax©) • Herpes Zoster • HSV encephalitis |
10 mg/kg q8h Actual weight, use IBW for obese pts (BMI > 30) |
CrCl > 50: No adjustment necessary CrCl 25-50: 10 mg/kg q12h CrCl 10-24.5: 10 mg/kg q24h CrCl < 10: 5 mg/kg q24h HD/PD: 2.5-5 mg/kg q24h |
|
| acyclovir IV (Zovirax©) • Herpes Simplex |
5 mg/kg q8h Actual weight, use IBW for obese pts (BMI > 30) |
CrCl > 50: No adjustment necessary CrCl 25-50: 5 mg/kg q12h CrCl 10-24.5: 5 mg/kg q24h CrCl < 10: 2.5 mg/kg q24h HD/PD: 2.5-5 mg/kg q24h |
|
| acyclovir PO (Zovirax©) |
200-800 mg 5x/day | CrCl > 25: No adjustment necessary CrCl 10-25: 200-800 mg q8h CrCl < 10: 200 mg q12h HD: 200 mg q12h PD: 600-800 mg daily |
|
| allopurinol PO (Zyloprim©) |
100-800 mg/day • Doses > 300 mg should be given in divided doses. • Higher doses of allopurinol should not be adjusted in patients who are suspected to be or are currently in tumor lysis syndrome (TLS). |
Dose evaluation to occur only upon order entry. CrCl > 20: No adjustment necessary CrCl 10-20: 200 mg daily CrCl 3-10: ≤ 100 mg daily CrCl < 3: ≤ 100 mg/dose at extended intervals |
|
| amantadine PO (Symmetrel©) • Non-Parkinson's |
100 mg q12h | CrCl > 50: No adjustment necessary CrCl 30-50: 200 mg x1, then 100 mg q24h CrCl 15-29: 200 mg x1, then 100 mg q48h CrCl <15: 200 mg q7days HD/PD: 200 mg q7days |
|
| AmBisome - see amphotericin B liposomal | |||
| amoxicillin PO 775 mg ER tabs |
775 mg q24h | CrCl > 30: No adjustment necessary CrCl < 30: Avoid use |
|
| amoxicillin PO 250-875 mg IR formulations |
250-500 mg q8h or 500-875 mg q12h Do not use 875 mg tablet for CrCl < 30 |
CrCl > 30: No adjustment necessary CrCl 10-30: 250-1,000 mg q12h CrCl < 10: 250-500 mg q12-24h HD/PD: 250-500 mg q12-24h |
|
| amoxicillin-clavulanate PO (Augmentin XR©) 1,000 mg ER tabs |
2,000 mg q12h Note: 1,000 mg XR tab not interchangable with 2 x 500 mg tabs |
CrCl > 30: No adjustment necessary CrCl < 30: Avoid use |
|
| amoxicillin-clavulanate PO (Augmentin©) 250-875 mg IR formulations |
500 mg q8-12h or 875 mg q12h Do not use 875 mg tablet for CrCl < 30 |
CrCl > 30: No adjustment necessary CrCl 10-30: 250-500 mg q12h CrCl < 10: 250 mg q12-24h HD: 250-500 mg q12-24h PD: 250-500 mg q12h |
|
| amphotericin B liposomal IV (AmBisome©) |
3-6 mg/kg q24h Actual weight |
No adjustment necessary | |
| ampicillin IV • Endocarditis |
2 gm q4h IV only, max 12 gm/day |
CrCl ≥ 50: No adjustment necessary CrCl 30-50: 2 gm q6h CrCl 15-30: 2 gm q8h CrCl < 15/HD/PD: 2 gm q12h |
|
| ampicillin IV/IM • Other infections |
1-2 gm q4-6h | CrCl ≥ 50: No adjustment necessary CrCl 30-50: 1-2 gm q8h CrCl < 15: 1-2 gm q12h CrCl < 15/HD/PD: 1-2 gm q24h |
|
| ampicillin-sulbactam IV/IM (Unasyn©) |
1.5-3 gm q6-8h | CrCl > 30: No adjustment necessary CrCl 15-29: 1.5-3 gm q12h CrCl 5-14: 1.5-3 gm q24h |
|
| Ancef - see ceFAZolin | |||
| anidulafungin IV (Eraxis©) |
Refer to  or other reference. |
No adjustment necessary | |
| Augmentin - see amoxicillin-clavulanate | |||
| Azactam - see aztreonam | |||
| azithromycin IV (Zithromax©) |
500 mg daily | No adjustment necessary | |
| azithromycin PO (Zithromax©) |
250-500 mg daily (500-1,000 mg single dose for specific indications) |
No adjustment necessary | |
| aztreonam IV/IM (Azactam©) |
1-2 gm q6-12h max 12 gm/day |
CrCl > 30: No adjustment necessary CrCl 10-30: 50% of dose, same interval CrCl < 10 or HD/PD: same dose q24h |
|
| B | Generic + Route (Brand) • Indications |
Usual Adult Dose Comments |
Renal Dosage Adjustments |
| Bactrim - see sulfamethoxazole-trimethoprim | |||
| baricitinib PO (Oluminant©) • COVID-19 infection |
4 mg once daily | eGFR ≥ 60: no adjustment necessary eGFR 30 – 60: 2 mg once daily eGFR 15 - 30: 1 mg once daily eGFR < 15: use is not recommended |
|
| Biaxin - see clarithromycin | |||
| C | Generic + Route (Brand) • Indications |
Usual Adult Dose Comments |
Renal Dosage Adjustments |
| caspofungin IV (Cancidas©) |
70 mg x1 then 50 mg/day |
No adjustment necessary | |
| ceFAZolin IV/IM (Ancef©) |
250 mg-2 gm q6-8h | CrCl > 50: 1-2 g q8h CrCl 30-50: 1-2 gm q8-12h CrCl 10-29: 1 gm q12h CrCl < 10 or HD: 1 gm q24h OR 2gm 3x/week with dialysis PD: 1 gm q24h |
|
| cefdinir PO (Omnicef©) |
300 mg BID | CrCl ≥ 30: No adjustment necessary CrCl < 30: 300 mg daily HD: 300 mg q48h at the end of HD session |
|
| cefepime IV (Maxipime©) • Sepsis • Febrile neutropenia • Pseudomonas |
2 gm q8h ONLY for severe infections |
For usual recommended dose = 2 gm q8h CrCl > 60: No adjustment necessary CrCl 30-60: 2 gm q12h CrCl 11-29: 1 gm q12h or 2 gm q24h CrCl < 11 or HD: 1 gm q24h |
|
| cefepime IV/IM (Maxipime©) • Other infections |
1-2 gm q8-12h | For usual recommended dose = 2 gm q12h CrCl > 60: No adjustment necessary CrCl 30-60: 1 gm q12h CrCl 11-29: 1 gm q24h CrCl < 11 or HD: 500 mg q24h |
|
| cefepime IV/IM (Maxipime©) • Other infections |
1-2 gm q8-12h | For usual recommended dose = 1 gm q6h CrCl > 60: No adjustment necessary CrCl 30-60: 1 gm q8h CrCl 11-29: 1 gm q12h CrCl < 11 or HD: 1 gm q24h |
|
| cefepime IV/IM (Maxipime©) • Other infections |
1-2 gm q8-12h | For usual recommended dose = 1 gm q12h CrCl > 60: No adjustment necessary CrCl 30-60: 1 gm q24h CrCl 11-29: 500 mg q24h CrCl < 11 or HD: 250 mg q24h |
|
| cefotaxime IV/IM (Claforan©) |
usual indication-specific dose = 2 gm q4h |
CrCl > 50: No adjustment necessary CrCl > 10-50: 2 gm q6-8h CrCl ≤ 10: 2 gm q12h HD (3x weekly): 2 gm q12h PD: 2 gm q12h |
|
| cefotaxime IV/IM (Claforan©) |
usual indication-specific dose = 1-2 gm q6h |
CrCl > 50: No adjustment necessary CrCl > 10-50: 1-2 gm q8h CrCl ≤ 10: 1-2 gm q12h HD (3x weekly): 1-2 gm q12h PD: 1-2 gm q12h |
|
| cefotaxime IV/IM (Claforan©) |
usual indication-specific dose = 1-2 gm q8h |
CrCl > 50: No adjustment necessary CrCl > 10-50: 1-2 gm q12h CrCl ≤ 10: 1-2 gm q24h HD (3x weekly): 1-2 gm q24h PD: 1-2 gm q24h |
|
| cefOXitin IV/IM (Mefoxin©) |
1-2 gm q6-8h | CrCl > 50: No adjustment necessary CrCl 30-50: 1-2 gm q8-12h CrCl 10-29: 1-2 gm q12-24h CrCl 5-9: 0.5-1 gm q12-24h CrCl < 5: 0.5-1 gm q24-48h |
|
| ceftaroline IV/IM (Teflaro©) |
600 mg q8-12h Restricted to ID only! |
CrCl > 50: No adjustment necessary CrCl 31-50: 400 mg q12h CrCl 15-30: 300 mg q12h CrCl < 15: 200 mg q12h HD: 200 mg q12h |
|
| cefTAZidime IV (Fortaz©) |
1-2 gm q8h 2 gm for meningitis, severe infections |
CrCl > 50: No adjustment necessary CrCl 31-50: 1-2 gm q12h CrCl 16-30: 1-2 gm q24h CrCl < 15: 0.5-1 gm q24h HD/PD: 1 gm q24h OR 3x/week post HD |
|
| Ceftin - see cefuroxime | |||
| cefTRIAXone IV/IM (Rocephin©) |
1-2 gm q24h | No adjustment necessary | |
| cefuroxime IV/IM (Zinacef©) |
0.75-1.5 gm q8-12h | CrCl ≥ 30: No adjustment necessary CrCl 10-30: 0.75-1.5 gm q12h CrCl < 10, HD/PD: 0.75-1.5 gm q24h |
|
| cefuroxime PO (Ceftin©) |
250-500 mg q12h | CrCl ≥ 30: No adjustment necessary CrCl 10-30: 250 mg q24h CrCl < 10, HD/PD: 250 mg q48h |
|
| cephalexin PO (Keflex©) |
250-500 mg q6h | CrCl > 60: No adjustment necessary CrCl 10-59: 500 mg q8h CrCl < 10 or HD/PD: 500 mg q12h |
|
| ciprofloxacin IV (Cipro©) |
200-400 mg q8-12h q8h for pseudomonas |
CrCl ≥ 30: No adjustment necessary CrCl < 30: 200-400 mg q24h HD/PD: 200-400 mg q24h |
|
| ciprofloxacin PO (Cipro©) |
250-750 mg q12h | CrCl > 50: No adjustment necessary CrCl 30-50: 250-500 mg q12h CrCl < 30: 500 mg q24h HD/PD: 250-500 mg q24h |
|
| Claforan - see cefotaxime | |||
| clarithromycin PO (Biaxin©) XL tabs |
500-1000 mg q24h | CrCl > 30: No adjustment necessary CrCl < 30: decrease dose by 50% |
|
| clarithromycin PO (Biaxin©) IR tabs |
250-500 mg q12h | CrCl > 30: No adjustment necessary CrCl < 30: decrease dose by 50% |
|
| clindamycin IV/IM (Cleocin©) |
600-900 mg q6-8h | No adjustment necessary | |
| clindamycin PO (Cleocin©) |
150-450 mg q6-8h | No adjustment necessary | |
| Cubicin - see DAPTOmycin | |||
| D | Generic + Route (Brand) • Indications |
Usual Adult Dose Comments |
Renal Dosage Adjustments |
| DAPTOmycin IV (Cubicin©) • Not for pneumonia |
4-6 mg/kg q24h Actual body weight Restricted to ID only! |
CrCl ≥ 30: No adjustment necessary CrCl < 30: 4-6 mg/kg q48h |
|
| Demerol - see meperidine | |||
| dicloxacillin PO | 250-500 mg q6-8h | No adjustment necessary | |
| Dificid - see fidaxomicin | |||
| Diflucan - see fluconazole | |||
| doxycycline IV/PO (Vibramycin©) |
100 q12h | No adjustment necessary | |
| E | Generic + Route (Brand) • Indications |
Usual Adult Dose Comments |
Renal Dosage Adjustments |
| Eraxis - see anidulafungin | |||
| ertapenem IV/IM (INVanz©) |
1 gm q24h | CrCl > 30: No adjustment necessary CrCl ≤ 30: 500 mg q24h HD: 500 mg q24h |
|
| F | Generic + Route (Brand) • Indications |
Usual Adult Dose Comments |
Renal Dosage Adjustments |
| famotidine IV/PO (Pepcid©) |
40 mg q24h or 20 mg q12h |
IV Adjustments: CrCl > 50: 20 mg BID CrCl < 50: 20 mg daily PO Adjustments: CrCl > 60: 20 mg daily or BID CrCl 30-60: 10-20 mg daily CrCl < 30: 10 mg daily or 20 mg QOD |
|
| fidaxomicin PO (Dificid©) • Clostridium difficile |
200 mg BID x 10 days Restricted to ID only (NOT GI)! |
No adjustment necessary | |
| Flagyl - see metroNIDAZOLE | |||
| fluconazole IV/PO (Diflucan©) |
100-800 mg q24h | Administer 100% of the indication-specific loading initial dose recommended and then adjust daily dose CrCl > 50: No adjustment necessary CrCl ≤ 50: 50% of usual dose q24h HD: same loading dose, then 50% q24h |
|
| Fortaz - see cefTAZidime | |||
| Furadantin - see nitrofurantoin | |||
| I | Generic + Route (Brand) • Indications |
Usual Adult Dose Comments |
Renal Dosage Adjustments |
| INVanz - see ertapenem | |||
| K | Generic + Route (Brand) • Indications |
Usual Adult Dose Comments |
Renal Dosage Adjustments |
| Keflex - see cephalexin | |||
| ketorolac IV/IM (Toradol©) |
15-30 mg q6h, 15 mg dose for pts ≥ 65 yrs. max 120 mg per day (max 60 mg per day with renal impairment) Single doses of ketorolac > 30 mg are discouraged due to increased risk for nephrotoxicity. |
eGFR > 50 mL/min/1.73m2: no adjustment necessary eGFR < 50 mL/min/1.73m2: 7.5-15 mg q6h eGFR < 30 mL/min/1.73m2: avoid using all NSAIDS eGFR < 10 mL/min/1.73m2: Contraindicated |
|
| ketorolac PO (Toradol©) |
10 mg q4-6h max 40 mg per day |
eGFR > 50 mL/min/1.73m2: no adjustment necessary eGFR < 50 mL/min/1.73m2: 10 mg q4-6h (max 40 mg/day) eGFR < 30 mL/min/1.73m2: avoid using all NSAIDS eGFR < 10 mL/min/1.73m2: Contraindicated |
|
| L | Generic + Route (Brand) • Indications |
Usual Adult Dose Comments |
Renal Dosage Adjustments |
| levoFLOXacin PO/IV (Levaquin©) • Healthcare-associated Pneumonia (HAP) (7-14 days) • Community-acquired Pneumonia (CAP) (5 days) • Cellulitis • Severe infection |
750 mg q24h | CrCl ≥ 50: No adjustment necessary CrCl 20-50: 750 mg q48h CrCl < 20: 750 mg x1, then 500 mg q48h HD, intermittent (3x/week): 750 mg x 1 then EITHER 500 mg q48h OR 250 mg q24h |
|
| levoFLOXacin PO/IV (Levaquin©) • Community-acquired pneumonia (7-14 days) • Other infections |
500 mg q24h | CrCl ≥ 50: No adjustment necessary CrCl 20-50: 500 mg x1, then 250 mg q24h CrCl < 20: 500 mg x1, then 250 mg q48h HD, intermittent (3x/week): 500 mg x 1 then EITHER 250 mg q48h OR 125 mg q24h |
|
| levoFLOXacin PO/IV (Levaquin©) • Uncomplicated UTI |
250 mg q24h | CrCl ≥ 20: No adjustment necessary CrCl < 20: 250 mg q48h (unless uncomplicated UTI, where no adjustment is necessary) HD, intermittent (3x/week): 250 mg q48h |
|
| linezolid IV/PO (Zyvox©) |
400-600 mg q12h | No adjustment necessary | |
| M | Generic + Route (Brand) • Indications |
Usual Adult Dose Comments |
Renal Dosage Adjustments |
| MacroBid - see nitrofurantoin | |||
| Macrodantin - see nitrofurantoin | |||
| Maxipime - see cefepime | |||
| Mefoxin - see cefOXitin | |||
| meperidine IM/IV (Demerol©) • Analgesia |
25-150 mg q1-4h prn | Avoid use in renal impairment | |
| meperidine IV (Demerol©) • Post-op Shivering |
25-50 mg x1 | Avoid use in renal impairment | |
| meropenem IV (Merrem©) • CNS infections • Necrotizing fasciitis • Bone/Joint Infection |
2 gm q8h (3 hr infusion) Refer to |
CrCl > 50 mL/min: No adjustment necessary CrCl 25-49 mL/min: 2 gm q12h CrCl 10-24 mL/min: 1 gm q12h CrCl < 10 mL/min, HD: 1 gm q24h (give dose after HD) Continuous renal replacement therapy (CRRT): 2 gm q12h |
|
| meropenem IV (Merrem©) • Pseudomonas infection (susceptible to meropenem) • Acinetobacter infection (susceptible to meropenem) |
1 gm q8h (3 hr infusion) Refer to |
CrCl > 50 mL/min: No adjustment necessary CrCl 25-49 mL/min: 1 gm q12h CrCl 10-24 mL/min: 500 mg q12h CrCl < 10 mL/min, HD: 500 mg q24h (give dose after HD) Continuous renal replacement therapy (CRRT): 1 gm q12h |
|
| meropenem IV (Merrem©) • Pneumonia • Intra-abdominal infection • Neutropenic fever • Infections caused by ESBLs or cefTRIAXone-resistant organisms |
500 mg q6h (30 min infusion) Refer to |
CrCl > 50 mL/min: No adjustment necessary CrCl 25-49 mL/min: 500 mg q8h CrCl 10-24 mL/min: 500 mg q12h CrCl < 10 mL/min, HD: 500 mg q24h (give dose after HD) Continuous renal replacement therapy (CRRT): 500 mg q6h |
|
| metoclopramide IV/PO (Reglan©) |
Refer toor other reference. No distinction between IV/PO or indication |
CrCl > 60: No adjustment necessary CrCl 11-59: Administer 50% of usual total daily dose. CrCl <11,HD/PD: Administer 33% or less of total daily dose. |
|
| metroNIDAZOLE IV/PO (Flagyl©) |
250-1,000 mg q8h | No adjustment necessary | |
| micafungin IV (Mycamine©) |
100-150 mg q24h | No adjustment necessary | |
| N | Generic + Route (Brand) • Indications |
Usual Adult Dose Comments |
Renal Dosage Adjustments |
| nafcillin IV | 1-2 gm q4-6h max 12 gm per day |
No adjustment necessary | |
| nitrofurantoin PO (Macrodantin/Furadantin©) |
50-100 mg q6h | CrCl ≥ 30: No adjustment necessary CrCl < 30: Contraindicated |
|
| nitrofurantoin PO (MacroBid©) |
100 mg BID | CrCl ≥ 30: No adjustment necessary CrCl < 30: Contraindicated |
|
| O | Generic + Route (Brand) • Indications |
Usual Adult Dose Comments |
Renal Dosage Adjustments |
| Oluminant - see baricitinib | |||
| Omnicef - see cefdinir | |||
| oseltamivir PO (Tamiflu©) • Prophylaxis |
75 mg q24h x 10 days |
CrCl > 60: No adjustment necessary CrCl 30-60: 30 mg q24h CrCl ≤ 30: 30 mg q48h ESRD/HD: not recommended (not studied) |
|
| oseltamivir PO (Tamiflu©) • Treatment |
75 mg q12h x 5 days (start within 48 hrs of onset) |
CrCl > 60: No adjustment necessary CrCl 30-60: 30 mg q12h CrCl ≤ 30: 30 mg q24h ESRD/HD: not recommended (not studied) |
|
| P | Generic + Route (Brand) • Indications |
Usual Adult Dose Comments |
Renal Dosage Adjustments |
| penicillin G potassium | 1-6 million units q4h | GFR > 50: No adjustment necessary GFR 10-50: Administer 75% of the normal dose GFR < 10: Administer 20-50% of the normal dose HD/PD: See Lexicomp |
|
| Pepcid - see famotidine | |||
| piperacillin-tazobactam IV (Zosyn©) • Extended Interval Dosing |
3.375 gm q8-12h 4 hour infusion All orders for traditional infusions of piperacillin-tazobactam will be automatically substituted to an EI in adults. Refer to |
CrCl > 20: 3.375 gm IV q8h CrCl ≤ 20 mL/min or HD: 3.375 gm IV q12h |
|
| piperacillin-tazobactam IV (Zosyn©) • Traditional Dosing |
3.375 gm q6h or 4.5 gm q6-8h 30 minute infusion |
For HAP: CrCl > 40: 4.5 gm q6h CrCl 20-29: 4.5 gm q8h or 3.375 gm q6h CrCl < 20: 4.5 gm q12h or 2.25 gm q6h HD/PD: 4.5 gm q12h or 2.25 gm q8h |
|
| R | Generic + Route (Brand) • Indications |
Usual Adult Dose Comments |
Renal Dosage Adjustments |
| Reglan - see metoclopramide | |||
| rifAMPin IV/PO | 300-600 mg daily | No adjustment necessary | |
| Rocephin - see cefTRIAXone | |||
| S | Generic + Route (Brand) • Indications |
Usual Adult Dose Comments |
Renal Dosage Adjustments |
| Septra - see sulfamethoxazole-trimethoprim | |||
| sulfamethoxazole-trimethoprim IV (Bactrim/Septra©) |
8-20 mg/kg/day (TMP component) divided q6-12h Actual body weight |
CrCl > 30: No adjustment necessary CrCl 15-30: Reduce to 50% of usual dose CrCl < 15/HD/PD: Reduce to 25-50% of usual dose |
|
| sulfamethoxazole-trimethoprim PO (Bactrim/Septra©) |
1-2 DS tablets q12-24h | CrCl > 30: No adjustment necessary CrCl 15-30: Reduce to 50% of usual dose CrCl < 15/HD/PD: Reduce to 25-50% of usual dose or 3x/week |
|
| Symmetrel - see amantadine | |||
| T | Generic + Route (Brand) • Indications |
Usual Adult Dose Comments |
Renal Dosage Adjustments |
| Tamiflu - see oseltamivir | |||
| Teflaro - see ceftaroline | |||
| Toradol - see ketorolac | |||
| U | Generic + Route (Brand) • Indications |
Usual Adult Dose Comments |
Renal Dosage Adjustments |
| Unasyn - see ampicillin-sulbactam | |||
| Unipen - see nafcillin | |||
| V | Generic + Route (Brand) • Indications |
Usual Adult Dose Comments |
Renal Dosage Adjustments |
| valACYclovir PO (Valtrex©) |
Refer to or other reference. |
For usual recommended dose = 2 gm q12h x 2 doses CrCl ≥ 50: No adjustment necessary CrCl 30-50: 1 gm q12h x 2 doses CrCl 10-30: 500 mg q12h x 2 doses CrCl < 10: 500 mg as a single dose |
|
| valACYclovir PO (Valtrex©) |
Refer to or other reference. |
For usual recommended dose = 1 gm q8h CrCl ≥ 50: No adjustment necessary CrCl 30-50: 1 gm q12h CrCl 10-30: 1 gm q24h CrCl < 10: 500 mg q24h |
|
| valACYclovir PO (Valtrex©) |
Refer to or other reference. |
For usual recommended dose = 1 gm q12h CrCl ≥ 50: No adjustment necessary CrCl 30-50: No adjustment necessary CrCl 10-30: 1 gm q24h CrCl < 10: 500 mg q24h |
|
| valACYclovir PO (Valtrex©) |
Refer to or other reference. |
For usual recommended dose = 1 gm q24h or 500 mg q12h CrCl ≥ 50: No adjustment necessary CrCl 30-50: No adjustment necessary CrCl 10-30: 500 mg q24h CrCl < 10: 500 mg q24h |
|
| valACYclovir PO (Valtrex©) |
Refer to or other reference. |
For usual recommended dose = 500 mg q24h CrCl ≥ 50: No adjustment necessary CrCl 30-50: No adjustment necessary CrCl 10-30: 500 mg q48h CrCl < 10: 500 mg q48h |
|
| valGANciclovir PO (Valcyte©) • Induction |
900 mg 1-2 x Daily | CrCl ≥ 60: No adjustment necessary CrCl 40-59: 450 mg BID CrCl 25-39: 450 mg daily CrCl 10-24: 450 mg QOD CrCl < 10: Avoid use |
|
| valGANciclovir PO (Valcyte©) • Maintenance therapy of CMV or transplant pts. |
900 mg Daily | CrCl ≥ 60: No adjustment necessary CrCl 40-59: 450 mg daily CrCl 25-39: 450 mg QOD CrCl 10-24: 450 mg twice weekly CrCl < 10: Avoid use |
|
| Vibramycin - see doxycycline | |||
| voriconazole IV (Vfend©) |
6 mg/kg q12h x 2 doses, then 3-4 mg/kg q12h | No adjustment necessary | |
| voriconazole PO (Vfend©) |
Wt ≥ 40 kg: 200 mg q12h Wt < 40 kg: 100 mg q12h |
No adjustment necessary | |
| Z | Generic + Route (Brand) • Indications |
Usual Adult Dose Comments |
Renal Dosage Adjustments |
| Zinacef - see cefuroxime | |||
| Zithromax - see azithromycin | |||
| Zosyn - see piperacillin-tazobactam | |||
| Zovirax - see acyclovir | |||
| Zyloprim - see allopurinol | |||
| Zyvox - see linezolid | |||
| last updated: 03/06/2023 | |||