In the setting of rapidly improving/worsening renal function, calculations of eGFR are inaccurate, and dosing should be based on estimated renal function instead.
If worsening renal function, actual GFR is likely lower than calculated.
If improving renal function, actual GFR is likely higher than calculated eGFR.
Not On Dialysis: Treatment (EGFR)
30mg PO daily x 5 days
75mg PO daily x 5 days
or
30mg PO BID x 5 days
75mg PO BID x 5 days
Not On Dialysis: Prophylaxis (EGFR)
30mg PO every other day until outbreak is over
30mg PO daily until outbreak is over
75mg PO daily until outbreak is over
Intermittent Dialysis
30mg PO on day 1, then 30mg PO after each HD for 5 days
30mg PO on day 1, then 30mg PO after each HD until outbreak is over
Continuous Dialysis
75mg PO daily x 5 days
75mg PO every other day until outbreak is over