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.
CrCl > 60ml/min
No dosage adjusmtent
CrCl >30 to 60ml/min
30mg PO BID
CrCl >10 to 30ml/min
30mg PO Daily
30mg PO load then 30mg PO after each HD session for 5 day period
30mg PO q24h