🫘 Renal Dose Adjustment Quick Reference
Quick reference for adjusting common renally-cleared drugs by CrCl/eGFR — DOACs, metformin, enoxaparin, gabapentinoids, NSAIDs and more. Browser-side.
Renal Dose Adjustment Quick Reference
Drug
When to use
Bedside reminder of renal thresholds and adjustments for 13 commonly used drugs. Not exhaustive — confirm against the latest label.
How it works
Per-drug bands by CrCl/eGFR (e.g. metformin contraindicated < 30; apixaban 2.5 mg BID if ≥ 2 of age ≥ 80 / weight ≤ 60 kg / SCr ≥ 1.5).
Key points
- Thresholds change with label updates — always verify the current label.
- Match the renal-function method (Cockcroft-Gault vs CKD-EPI) to the drug's PK studies.
- NSAIDs: avoid below eGFR 30 and beware the ACEI/ARB + diuretic 'triple whammy'.
- Individualise to the whole patient and institutional protocol.
References
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.