Dialysis of Drugs

The guidelines contained in this application are designed to provide extensive, easy-to-read information regarding the dialyzability of drugs. Numerous literature sources have been used in preparing the guidelines. For many drugs, including newly-approved medications, investigational agents and medications available in other countries, there have been no dialysis pharmacokinetic studies. In some cases, the available data may conflict. Conditions of dialysis used in published studies may not reflect current dialysis practice and technology. Variations in the duration of dialysis, blood and dialysate flow rates, dialysis membranes, and whether peritoneal dialysis is continuous or intermittent, will all affect drug removal. These guidelines distinguish between conventional hemodialysis and high permeability (high-flux) hemodialysis where such data are available. No information is provided on drug dialyzability with continuous renal replacement therapy (CRRT) or with plasmapheresis. For additional information on specific drugs, the reader should consult the primary literature. Users of this application are referred to www.renalpharmacyconsultants.com for background and explanatory material to assist in the interpretation of the tabular data. The website provides specific information about factors that influence drug dialyzability and special considerations, such as CRRT, plasmapheresis and drugs of abuse. Users must be familiar with this information prior to using the content of this application. The website also includes a table presenting sieving coefficient data from in vitro and in vivo evaluations, which can be used to predict dosing requirements in CRRT, and a table regarding removal of drugs of abuse.