Appendix 1: List of Study Medications and Alert Comments
Drug
Display Comment
Alendronate
CLcr < 35 mL/min
This patient's CLcr is less than 35 mL/min. Avoid
alendronate use in patients with renal impairment.
Ampicillin-sulbactam IV
CLcr 15 – 30 mL/min
This paient's CLcr is 15-30 mL/min. Recommended
dose of ampicillin-sulbactam is 3 g Q12H.
Ampicillin-sulbactam IV
CLcr < 15 mL/min
Dabigatran
CLcr 15 – 30 mL/min
This paient's CLcr is less than 15 mL/min.
Recommended dose of ampicillin-sulbactam is 3 g
Q24H.
This patient's CLcr is less than 30 mL/min. Avoid use
of Augmentin XR or 875 mg tablets in patients with
renal impairment.
This patient's CLcr is less than 30 mL/min.
Recommended dose of ciprofloxacin is 200 - 400 mg
IV Q24H.
This patient's CLcr is less than 30 mL/min.
Recommended dose of clarithromycin is 250 mg PO
BID or 250 mg PO Q24H in dialysis-dependent
patients.
This patient's CLcr is 15-30 mL/min. Recommended
dose of dabigatran is 75 mg PO BID.
Dabigatran
CLcr < 15 mL/min
This patient's CLcr is less than 15 mL/min. Avoid
dabigatran use in patients with renal impairment.
Enoxaparin
CLcr < 30 mL/min
This patient's CLcr is less than 30 mL/min. Avoid
use of enoxaparin or contact pharmacokinetic service
for dosing.
This patient's CLcr is less than 50 mL/min. Avoid
using glyburide in patients with impaired renal
function. Consider alternative agent such as glipizide.
This patient's CLcr is less than 30 mL/min. Avoid use
of ibandronate in patients with impaired renal
function.
This patient's CLcr is less than 30 mL/min. Avoid
ibuprofen use in patients with impaired kidney
function.
This patient's CLcr is less than 30 mL/min. Avoid use
of ketorolac in patients with impaired renal function.
Augmentin XR
CLcr < 30 mL/min
Cipro IV
CLcr < 30 mL/min
Clarithromycin PO
CLcr < 30 mL/min
Glyburide
CLcr < 50 mL/min
Ibandronate
CLcr < 30 mL/min
Ibuprofen
CLcr < 30 mL/min
Ketorolac
CLcr < 30 mL/min
Meperidine
CLcr < 60 mL/min
Metformin
CLcr < 60 mL/min
This patient's CLcr is less than 60 mL/min. Avoid use
of meperidine in patients with impaired renal function.
Consider use of alternative agents such as
oxycodone or fentanyl.
This patient's CLcr is less than 60 mL/min. Avoid
using metformin in patients with impaired renal
funtion.
Metoclopramide IV
CLcr < 40 mL/min
This patient's CLcr is less than 40 mL/min. Max daily
dose of IV metoclopramide is 20 mg.
Metoclopramide PO
CLcr < 40 mL/min
This patient's CLcr is less than 40 mL/min. Max daily
dose of PO metoclopramide is 30 mg.
Naproxen
CLcr < 30 mL/min
This patient's CLcr is less than 30 mL/min. Avoid
naproxen in patients with impaired renal function.
Nitrofurantoin
CLcr < 60 mL/min
This patient's CLcr is less than 60 mL/min. Avoid
nitrofurantoin in patients with impaired renal function.
Risedronate
CLcr < 30 mL/min
This patient's is less than 30 mL/min. Avoid
risedronate use in patients with impaired renal
function.
This patient's CLcr is less than 30 mL/min.
Recommended dosing interval of tramadol is BID
and max daily dose is 200 mg.
This patient's CLcr is less than 9 mL/min. Avoid
valganciclovir use in patients with renal impairment.
Tramadol
CLcr < 30 mL/min
Valganciclovir
CLcr < 9 mL/min
Voriconazole IV
CLcr < 50 mL/min
This patient's CLcr is less than 50 mL/min. Avoid IV
voriconazole. If possible, use oral voriconazole in
patients with renal impairment.