Drug metabolism is altered in renal impairment and so doses and dosing intervals may need to be altered.
The best sources of information about prescribing in renal impairment are:
- the BNF (tends to be conservative and is restricted to licensed indications)
- the emc (licensed indications but more information than the BNF)
- the Renal Drug Database (has information on unlicensed indications; this is the continually update and online version of the “Renal Drug Handbook”)
- NHS Lothian shared care protocols
- Lothian joint formulary (click on adult, child etc as appropriate; other useful links listed also)
- the renal pharmacists
All doctors in NHS Scotland can (and should!) request access to the Renal Drug Database by e-mailing Knowledge@nes.scot.nhs.uk.
In this prescribing handbook, we have further advice on some specific drugs / drug classes that have particular issues in renal disease:
- ACE inhibitors / ARBs
- …and more
Acknowledgements: Robert Hunter and Maggie Davidson were the main authors for this page. The last modified date is shown in the footer.