Table 5.
Examples of discrepancies in recommendations across the information sources.
| Drugs | DRUGDEX® | UpToDate® | Medscape® | NTF |
|---|---|---|---|---|
| amphotericin B | ClCr > 10 mL/min: no adjustment required. ClCr < 10 mL/min: 20–50 mg every 24–36 hours. |
If renal dysfunction is drug-induced, the total daily dose can be reduced in 50% or given in alternate days. | ClCr < 10 mL/min: 0.5–0.7 mg/kg IV every 24–48 hours. Consider other antifungal agents with less nephrotoxicity. | ClCr 10–50 mL/min: doses every 24 hours. ClCr < 10 mL/min: doses every 24 or 36 hours. |
| bumetanide | No adjustment required. | Use is contraindicated in anuria. Use with caution in renal impairment. | No advice. | Missing. |
| carbamazepine | No adjustment required. | ClCr < 10 mL/min: administrate 75% of dose. | ClCr < 10 mL/min: administrate 75% of dose and monitor. | Missing. |
| fluoxetine | No adjustment required. | Use with caution. Drug accumulation may occur. | Use with caution. Drug accumulation may occur. | Missing. |
| heparin | No adjustment required. | No dose adjustment provided in the label of the manufacturer. | No advice. | Severe renal impairment: contraindicated. Renal impairment: reduce dose due to increased risk of bleeding. |
| losartan | No adjustment required. | No adjustment required. | No advice. | ClCr < 20 mL/min: reduce dose. Recommended: 25mg. |
| methylene blue | Dose adjustment should be considered (specific recommendations unavailable) | Be cautious in case of severe renal impairment. | No adjustment required. Be cautious in case of severe renal impairment. |
Missing. |
| neostigmine | No adjustment required. | ClCr > 50 ml/min: no adjustment required. ClCr 10–50 mL/min: administrate 50% of normal dose. ClCr < 10 mL/min: administrate 25% of normal dose. |
No advice. | Adjust dose in renal impairment. |
| rifampicin | ClCr ≤ 50 mL/min: 50%–100% of total dose. | No adjustment required. | No advice. | ClCr ≥ 50 mL/min: 100% of dose. ClCr < 49 mL/min: 50% of recommended dose. No need to adjust the dose if it does not exceed 600 mg/day and liver function is normal. |
| verapamil | No adjustment required. | Use with caution. | Use with caution. Manufacturer recommends 100 mg at bedtime. ClCr < 10 mL/min: reduce the dose in 25%–50%. |
Missing. |