Table 1.
ARVs and TB treatment use in renal dysfunction.
| CrCl (mL/min) | Haemodialysis (HD) (dose after dialysis) | Peritoneal dialysis | Continuous renal replacement therapy | |||
|---|---|---|---|---|---|---|
| >50 (Usual adult dose) | 10–50 | < 10 | ||||
| NRTIs | ||||||
| Abacavir | 600 mg daily or 300 mg twice daily | No adjustment | No adjustment | No adjustment | No adjustment | No adjustment |
| Emtricitabine capsules | 200 mg daily | 30–49: 200 mg q48h 15–29: 200 mg q72h |
< 15: 200 mg q96h | 200 mg q96h | No data | No data |
| Emtricitabine oral solution | 240 mg daily | 30–49: 120 mg q24h 15–29: 80 mg q24h |
< 15: 60 mg q24h | 60 mg q24h | No data | No data |
| Lamivudine | 300 mg daily or 150 mg twice daily | 50–150 mg q24h | 25–50 mg q24h | 25–50 mg q24h | 25–50 mg q24h | 100 mg first day, then 50 mg q24h |
| Stavudine | 30–40 mg twice daily | 15–20 mg q12h | ≥ 60 kg: 20 mg q24h < 60 kg: 15 mg q24h | ≥ 60 kg: 20 mg q24h < 60 kg: 15 mg q24h | No data | 30–40 mg q12h |
| Tenofovir disoproxil fumarate | 300 mg daily | 30–49: 300 mg q48h 10–29: 300 mg q72–96h |
No data | 300 mg q7d | No data | No data |
| Zidovudine | 300 mg twice daily | No adjustment | 100mg q8h or 300 mg daily | 100 mg q8h or 300 mg daily | No data | 300 mg q12h |
| NNRTIs | ||||||
| Efavirenz, etravirine, nevirapine (NVP), rilpivirine, delavirine | No adjustment | No adjustment | No adjustment, except when on NVP patients should receive an additional dose of NVP 200 mg following each dialysis treatment | No adjustment | No adjustment | |
| PIs | ||||||
| Atazanavir (ATV), darunavir, fosamprenavir, lopinavir/ritonavir (LPV/r), ritonavir (r), nelfinavir, saquinavir, Tipranavir | No adjustment | No adjustment | No adjustment, except in ARV-experienced patients on HD: ATV and ATV/r are not recommended; also avoid once-daily dosing of LPV/r. | No adjustment | No adjustment | |
| INSTIs | ||||||
| Dolutegravir, raltegravir | No adjustment | No adjustment | No adjustment | No adjustment | No adjustment | |
| Binding – Entry Inhibitors | ||||||
| Enfuvirtide | No adjustment | No adjustment | No adjustment | No adjustment | No adjustment | |
| Maraviroc | CrCl < 30: Without potent CYP3A inhibitors or inducers: 300 mg twice daily, reduce to 150 mg twice daily if postural hypotension occurs With potent CYP3A inhibitors or inducers: Not recommended |
Without potent CYP3A inhibitors or inducers: 300 mg twice daily, reduce to 150 mg twice daily if postural hypotension occurs With potent CYP3A inhibitors or inducers: Not recommended |
No data | No data | ||
| TB drugs | ||||||
| Rifampicin | 8–12 mg/kg q24h | 300–600 mg q24h | 300–600 mg q24h | 300–600 mg q24h | 300–600 mg q24h | 300–600 mg q24h |
| Isoniazid | 4–6 mg/kg q24h | No adjustment | No adjustment | No adjustment | No adjustment | No adjustment |
| Ethambutol | 15–25 mg/kg q24h | 30–50: 15–25 mg/kg q24–36h 10–30: 15–25 mg/kg q36–48h |
15 mg/kg q48h | 15 mg/kg q48h | 15 mg/kg q48h | 15–25 mg/kg q24h |
| Pyrazinamide | 25 mg/kg q24h | 21–50: 25 mg/kg q24h 10–20: 25 mg/kg q48h |
25 mg/kg q48h | 25 mg/kg q48h | 25 mg/kg q24h | 25 mg/kg q24h |
This table is not exhaustive. Antiretrovirals such as tenofovir alafenamide, bictegravir and elvitegravir that are only available as combination products have not been included.
This table was compiled using:
- Gilbert DN, Eliopoulos GM, Chambers HF, Saag, MS, Pavia, AT, eds. 2019. The Sanford guide to antimicrobial therapy 2019 [Electronic version]. Sperryville, VA: Antimicrobial Therapy, Inc.; 2019. https://webedition.sanfordguide.com/en. Accessed 21 October 2019.
- Guidelines for the use of antiretroviral agents in adults and adolescents with HIV. Downloaded from https://aidsinfo.nih.gov/guidelines on 22 October 2019.
ARV, antiretroviral; INSTI, integrase strand transfer inhibitor; NNRTI, non-nucleotide reverse transcriptase inhibitor; NRTI, nucleotide reverse transcriptase inhibitor; PI, protease inhibitor; TB, tuberculosis.