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ALL / Pharmacology

Prescribing in patients with renal failure

Prescribing in patients with renal failure

Questions regarding which drugs to avoid in renal failure are common

Drugs to avoid in renal failure
  • antibiotics: tetracycline, nitrofurantoin
  • NSAIDs
  • lithium
  • metformin

Drugs likely to accumulate in chronic kidney disease - need dose adjustment
  • most antibiotics including penicillins, cephalosporins, vancomycin, gentamicin, streptomycin
  • digoxin, atenolol
  • methotrexate
  • sulphonylureas
  • furosemide
  • opioids

Drugs relatively safe - can sometimes use normal dose depending on the degree of chronic kidney disease
  • antibiotics: erythromycin, rifampicin
  • diazepam
  • warfarin
+PassMedicine Notes

Questions regarding which drugs to avoid in renal failure are common

Drugs to avoid in renal failure
  • antibiotics: tetracycline, nitrofurantoin
  • NSAIDs
  • lithium
  • metformin
Drugs likely to accumulate in chronic kidney disease - need dose adjustment
  • most antibiotics including penicillins, cephalosporins, vancomycin, gentamicin, streptomycin
  • digoxin, atenolol
  • methotrexate
  • sulphonylureas
  • furosemide
  • opioids
Drugs relatively safe - can sometimes use normal dose depending on the degree of chronic kidney disease
  • antibiotics: erythromycin, rifampicin
  • diazepam
  • warfarin


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