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. 2023 Jul 17;21(4):609–616. doi: 10.9758/cpn.23.1081

Table 2.

Dosing in adults and special populations [16]

Patient population Initial dosing Maintenance dosing
Adults 45/105 mg daily × 3 days 45/105 mg twice dailya
Hepatic impairment
Child Pugh A−B 45/105 mg daily × 3 days 45/105 mg twice
Child Pugh C Not recommended, no data studied
Renal impairment
eGFR 30−59 45/105 mg daily 45/105 mg daily
eGFR < 30 Not recommended, no data studied
Poor CYP2D6 metabolizers 45/105 mg daily 45/105 mg daily
Concomitant strong CYP2D6 inhibitor use 45/105 mg daily 45/105 mg daily

eGFR, estimated glomerular filtration rate.

aDosing should be at least 8 hours apart. Do not exceed 2 tablets in 24 hours.