In the setting of rapidly improving or worsening renal function, calculations of CrCl are inaccurate. Dosing should be based on estimated renal function instead.
If improving renal function, actual CrCl is likely higher than calculated CrCl.
If worsening renal function, actual CrCl is likely lower than calculated CrCl.
Not on Dialysis
300mg PO Q12h or 600mg PO Q24h
300mg PO Q24h
300mg PO Q48h
Intermittent Dialysis (IHD)
300mg PO every other day (doses given on HD days should be given after HD)
Continuous Dialysis (CRRT)
300mg PO Q24h