- The doses quoted are for haemodialysis (HD), peritoneal dialysis (PD) and patients with creatinine clearance less than 30mL/min.
- The doses quoted are suggested starting doses; these can be gradually increased as necessary according to response. Review analgesia regularly, at least once a day. Increased dose or increased frequency will depend on pain relief verses side-effects with current dose, but will be patient-specific.
- Avoid modified release preparations in renal impairment as drug half life will be further extended and increase the risk of accumulation.
To calculate estimated creatinine clearance use the equation below:
Est CrCl (mL/min) = (140 – age) x body weight (kg) x 1·23 for men or 1·04 for women
This equation is less accurate at extremes of weight. In obese patients use ideal body weight calculated as below.
If further advice is needed contact pharmacy.
Ideal body weight
Males = 50kg + 0·9kg for every cm above 150cm
Females= 45·5kg + 0·9kg for every cm above 150cm