. 2010 Sep 17;107(37):647–656. doi: 10.3238/arztebl.2010.0647

Table 3. The most important drugs whose use in patients with renal insufficiency is absolutely or relatively contraindicated or problematic from a clinical nephrological standpoint^*1.

Class	Drug	Contraindicated or to be avoided if possible when:	Reason
Analgesics	Pethidine	GFR <60	Convulsions
Antibiotics	Cefepime	GFR <30	CNS toxicity
Phase-prophylactic psychotropic drugs	Lithium	GFR <60	Nephro- and neurotoxicity
Antidiabetic drugs	Glibenclamide, gimepiride	GFR <60	Hypoglycemia
	Metformin	GFR <60	Lactic acidosis
Diuretics	Spironolactone, eplerenone	GFR <30	Hyperkalemia
Immune suppressants	Methotrexate	GFR <60	Myelotoxicity
Radiological contrast media	Gadolinium	GFR <30	Nephrogenic systemic fibrosis
LMW-heparin	Enoxaparin	GFR <60	Risk of hemorrhage

^*1 after (4)

Table 3. The most important drugs whose use in patients with renal insufficiency is absolutely or relatively contraindicated or problematic from a clinical nephrological standpoint*1.