Appendix 1.
Prescribing Recommendations for Primarily Renally Cleared Medications*
| Medication | Creatinine Clearance, mL/min | Maximum Dosing Recommendation, mg |
|---|---|---|
| Acyclovir (zoster) | 10–29 | 800 every 8 hours |
| Acyclovir (zoster) | <10 | 800 every 12 hours |
| Amantadine | 30–59 | 100 daily |
| Amantadine | 15–29 | 100 every 48 hours |
| Amantadine | <15 | 100 every 7 days |
| Chlorpropamide | <50 | Avoid use |
| Ciprofloxacin | <30 | 500 every 24 hours |
| Colchicine | <10 | Avoid use |
| Duloxetine† | <30 | Avoid use |
| Gabapentin | 30–59 | 600 twice daily |
| Gabapentin | 15–29 | 300 twice daily |
| Gabapentin | <15 | 300 daily |
| Glyburide | <50 | Avoid use |
| Levetiracetam† | 50–80 | 500–1000 every 12 hours |
| Levetiracetam† | 30–50 | 250–750 every 12 hours |
| Levetiracetam† | <30 | 250–500 every12 hours |
| Memantine | <30 | 5 twice daily |
| Meperidine | <50 | Avoid use |
| Nitrofurantoin | <60 | Avoid use |
| Probenecid | <50 | Avoid use |
| Propoxyphene | <10 | Avoid use |
| Ranitidine | <50 | 150 daily |
| Rimantidine | <50 | 100 daily |
| Sulfamethoxazole/Trimethoprim | 15–29 | 800/160 daily |
| Sulfamethoxazole/Trimethoprim | <15 | Avoid use |
| Spironolactone | <30 | Avoid use |
| Tramadol† | <30 | 50–100 every 12 hours |
| Triamterene | <30 | Avoid use |
| Valacyclovir | 30–49 | 1000 every 12 hours |
| Valacyclovir | 10–29 | 1000 every 24 hours |
| Valacyclovir | <10 | 500 every 24 hours |