Drugs Dosing in Renal Failure (RF) by Giusti-Hayton-Tozer's Formula, for Adult Patients.
It is advisable to compare the adjusted doses through GHT formula, with the values suggested in the bibliography below, as well as to see the 37 recommendations of citation 8.
=Use dot to separate decimals=
AF = Adjustment Factor. Method
D = Dosage reduction, normal interval.
Method I = Interval extension, normal dose.
Method D/I = Combination of both.
Dose for RF = mg, g or I.U.
Interval for RF = hours or days.
Special care: [a] No data on adjustment for RF.
[b] Avoid when CLcr ≤ 10ml/min.
[c] No data on adjustment for CLcr ≤ 10ml/min.
[d] Avoid when CLcr ≤ 30ml/min.
[e] No data on adjustment for CLcr ≤ 30ml/min.
[f] Avoid when CLcr ≤ 50ml/min.
[g] No data on adjustment for CLcr ≤ 50ml/min.
[h] Avoid when CLcr < 90ml/min.
[i] Active metabolites.
[j] Toxic metabolites.
[k] Use with extreme care.
[l] Attention to neurotoxicity.
[m] Attention to cardiotoxicity.
[n] Attention to nephrotoxicity.
[o] Warning for toxicity to the stomach.
[p] Attention to hepatotoxicity.
[q] Attention to myelotoxicity.
[r] Attention to rhabdomyolysis, myopathy.
[s] Can cause Nephrogenic Systemic Fibrosis.
AF = Adjustment factor. fe =
the larger fraction of active substances (drugs or metabolites) excreted by the kidneys in normal conditions. GFpat = Patient's Creatinine Clearance (or GFR) (ml/min). 120 = Normal Creatinine Clearance (or GFR) (ml/min).
*To calculate the AF use the CLcr or the GFR without standardization for 1.73m2 of body surface area. The calculators below reverses the CLcr or GFR to the unstandardized (unst.) value (unst. CLcr or GFR):
New or missing substances in the above drop-down list box
=Use dot to separate decimals=
**fe = the larger fraction of active substances (drugs or metabolites) excreted by the kidneys in normal conditions.
1. Aronoff GR, Bennett WM, Berns JS, Brier ME, Kasbekar N, Mueller BA, et al. Drug prescribing in renal failure: dosing guidelines for adults and children. 5th Ed. Philadelphia (PA): American College of Physicians; 2007.
2. Ashley C, Currie A.: The renal drug handbook. 4th ed. Oxford (UK): Radcliffe Medical Press; 2014.
3. Seyffart G. Seyffart's Directory of Drug Dosage in Kidney Disease. Dustri-Verlag Dr. Karl Feistle GmbH&Co. KG, Munich, 2011.
4. Cervelli MJ. The Renal Drug Reference Guide. Edited by Matthew J Cervelli, Adelaide, Australia; 2008.
5. Barsanulfo-Pereira E. Uso de Medicamentos na Insuficiência Renal. In Riella MC: Princípios de Nefrologia e Distúrbios Hidroeletrolíticos 5ª Ed., Cap. 50;902-938. Editora Guanabara-Koogan, Rio de Janeiro; 2010.
6. Golightly LK, Teitelbaum I, Kiser TH, Levin DA, Barber GR, Jones MA, Stolpman NM, Lundin KS. Renal Pharmacotherapy - Dosage Adjustment of Medications Eliminated by the Kidneys. Springer, NY, 2013.
7. Schrier RW, Gambertoglio JG.: Handbook of Drug Therapy in Liver and Kidney Disease. Little, Brown and Company, Boston, 1991.
8. Matzke GR, Aronoff GR, Atkinson Jr AJ, Bennett WM, Decker BS, Eckardt K-U, Golper T, Grabe DW, Kasiske B, Keller F, Kielstein JT, Mehta R, Mueller BA, Pasko DA, Schaefer F, Sica DA, Inker LA, Umans JG and Murray P. Drug dosing consideration in patients with acute and chronic kidney disease - a clinical update from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney International (2011) 80, 1122-1137.