DialyzeIHD: Dialyzability of Medications During Intermittent Hemodialysis % Dialyzed % Dialyzed % Dialyzed % Dialyzed IHD Dosing; Administration IHD Dosing; Administration IHD Dosing; Administration IHD Dosing; Administration Timing Drug (Type of Drug (Type of Drug (Type of Drug (Type of Timing Around HD Session Timing Around HD Session Around HD Session Dialyzer) Timing Around HD Session Dialyzer) Dialyzer) Dialyzer) 0.25-0.5mg PO Q8H PRN, Insulin Aspart, Pentamidine 0 4mg/kg IV Q24-36H, Not recommended for use, Clonazepam N/A Reduce to 25-50% of normal dose Acarbose N/A Administer anytime during HD Insulin Detemir, Isethionate (N/A) Administer anytime during HD Administer anytime during HD N/A and titrate, Administer anytime Insulin Glargine, 0.1-0.4mg PO Q8-12H, during HD Normal dose and titrate based on 100-150mg PO Q12-24H, <5 Insulin Lispro Acebutolol N/A Clonidine Administer anytime during HD; No target free or corrected total Administer post-HD (Low Flux) Phenytoin Dose post-HD if hypotensive 75-300mg PO Q24H, (Low Flux) phenytoin level, Normal dose based on indication, 0 Administer anytime during HD Acetaminophen N/A 75mg PO Q24H, Irbesartan Administer anytime during HD; Dose Administer anytime during HD Clopidogrel N/A (N/A) Administer anytime during HD post-HD if hypotensive No 15-45mg PO Q24H, Pioglitazone 2.5-5mg/kg IV/PO Q24H, (N/A) Administer anytime during HD 40-60 250-500mg PO Q6H or 1-2g IV Q4- 100mg IV weekly to monthly, Acyclovir Administer post-HD over 60 Cloxacillin N/A Iron Dextran N/A (N/A) 6H, Administer anytime during HD Administer anytime during HD Piperacillin/ 10-65 2.25g-4.5g IV Q12H, minutes Tazobactam (Low Flux) Administer post-HD over 30 minutes Reduce to 50% of normal dose and 100mg IV weekly to monthly, Normal dose based on blood work, Iron Sucrose N/A Alfacalcidol N/A titrate, Administer post -HD Administer anytime during HD 0 Normal dose based on indication, Administer anytime during HD Codeine N/A Posaconazole (if given on HD, may require (N/A) Administer anytime during HD 0.25-0.5mg PO Q8H PRN, supplemental dose post -HD) Isosorbide Minimal 5-40mg PO Q8H, Alprazolam N/A 10-80mg PO Q24H, Administer anytime during HD Dinitrate (N/A) Administer post-HD Pravastatin N/A 22-36.7 Reduce to 75% of normal dose Administer post-HD 2-5 100mg PO Q7days, Cyclophosphamide (over 3- 4 hrs) based on indication, 0 100-200mg PO Q24H, Amantadine (Low Flux) Itraconazole Minimal 1-5mg PO Q8-12H, (Low Flux) Administer anytime during HD Administer post-HD over 20-60 min (High Flux) Administer anytime during HD Prazosin (N/A) Administer anytime during HD Dose based on indication and LD 5-7.5mg/kg IV, then MD 5mg/kg <1 AVOID if possible; 10mg PO Q12H, Cyclosporine target serum level, Normal dose based on indication, 18.5-88 IV QHD (Once daily dosing NOT (Low Flux) Ketorolac N/A Amikacin Administer anytime during HD Administer anytime during HD Prednisone N/A (Low Flux) recommended), Administer post- Administer anytime during HD HD (or over last 10 minutes of HD) 68 AVOID use, 100-400mg PO Q12H, Dabigatran <1 80-160mg PO Q12H, (N/A) Not recommended Labetalol Administer anytime during HD; Dose Propranolol <5 (N/A) Administer anytime during HD; Dose Minimal Normal dose based on indication, (Low Flux) Amiodarone post-HD if hypotensive post-HD if hypotensive (N/A) Administer anytime during HD 100mg PO Q24H, Dapsone N/A Administer anytime during HD 17 Normal dose based on indication, 2.5-10mg PO Q24H, Minimal 2.5-10mg PO Q24H, Lamotrigine 12 Amlodipine (N/A) Administer post-HD Quinapril Administer anytime during HD; Dose (N/A) Administer anytime during HD 6mg/kg IV QHD, (Low Flux) 39-58 post-HD if hypotensive Daptomycin Administer post-HD over 10 30-47 500mg PO Q24H, (High Flux) Normal dose based on blood work, Amoxicillin minutes Lanthanum N/A Yes 200-300mg PO HS or on HD, (Low Flux) Administer post-HD Administer anytime during HD Quinine No (N/A) Administer anytime during HD 0.45mcg/kg/week IV/SC initially, LD 500mg IV/PO, then 250-500mg 0 Normal dose based on indication, Darbepoetin (High & Low 10-21 Amphotericin B Administer anytime during HD Levofloxacin IV/PO Q48H, Administer post-HD Minimal 1.25-5mg PO Q24H, (High Flux) Administer anytime during HD Flux) (High Flux) Ramipril over 60 minutes (Low Flux) Administer post-HD 5mg/kg/week IV, 13-27 0 Dose based on indication, Amphotericin B 0 5mg/kg IV Q24H Deferoxamine Administer post-HD or during last 32-37 600mg IV/PO Q12H, Rituximab (Low Flux) Linezolid (N/A) Administer anytime during HD Lipid Complex (High Flux) Administer anytime during HD hour of HD (Low Flux) Administer post-HD over 30 minutes Normal dose based on indication, 5-40mg PO Q24H, Diazepam N/A 51 2.5-10mg PO Q24-48H, Rosuvastatin N/A 1000mg IV Q12H, Administer anytime during HD Lisinopril Administer anytime during HD 35-40 (Low Flux) Administer post-HD Ampicillin Administer post-HD (Low Flux) AVOID if possible; 25mg PO Q12H, Dose based on blood work, (or last 10 minutes of HD) Diclofenac N/A Reduce to 25-50% of normal dose; Sevelamer N/A Administer anytime during HD Administer anytime during HD Yes Lithium titrate based on target serum level, 50-100 81-325mg PO Q24H (varies based (N/A) ASA LD 0.5-0.75mg (if required), then Administer post-HD Minimal 10-40mg PO Q24H, (N/A) on indication), Administer post-HD Simvastatin Digoxin N/A MD 0.0625mg PO QHD, (N/A) Administer anytime during HD Administer anytime during HD 8 0.5-1mg PO Q8H PRN, 75 25mg PO Q24H, Lorazepam 0 Normal dose based on target serum Atenolol (Low Flux) Administer anytime during HD Sirolimus (Low Flux) Administer post-HD 120-360mg PO Q24H (sustained (N/A) level, Administer anytime during HD Minimal 10-80mg PO Q24H, release), Administer anytime 50-100mg PO Q24H, Atorvastatin Diltiazem N/A 0 Sodium Ferric <1 125mg IV weekly to monthly, (N/A) during HD; Dose post-HD if Losartan Administer anytime during HD; Dose Administer anytime during HD (High Flux) (N/A) Administer anytime during HD hypotensive post-HD if hypotensive Gluconate Reduce to 50% of normal dose 12.5-25mg IV thrice weekly, 45 25-50mg PO/IV/SC Q8H PRN >32 Azathioprine based on indication, Dimenhydrinate N/A 50-70 500-1000mg IV Q24H, Sodium Thiosulfate Administer post-HD over 30-60 (N/A) Administer anytime during HD Meropenem (High Flux) Administer post-HD (Low Flux) Administer post-HD over 15 minutes minutes 25-50mg PO/IV/SC Q6H PRN 250-500mg PO or 500mg IV Q24H, Diphenhydramine N/A Reduce to 50-75% of normal dose 20 40mg PO Q24H, Azithromycin N/A Administer anytime during HD 1-18 Sotalol Administer anytime during HD Methadone and titrate, Administer anytime (low Flux) Administer post-HD (Low Flux) Dose based on indication and during HD LD 1000mg IV, then 500mg IV 1-2g IV Q72-96H, target free valproic acid level, Streptomycin N/A 40 Q12H, 63 AVOID use, Administer post-HD Aztreonam Administer post-HD, if feasible . Methotrexate (Low Flux) Administer post-HD over 20 Divalproex N/A (High Flux) Not recommended minutes For seizure indication, administer Not recommended; 800/160mg Q12H but may require Sulfamethoxazole/ 60 250mg PO Q12-24H, 2-57 (Double Strength tablet) PO or 2.5- Normal dose based on indication, supplemental dose post-HD. Methyldopa Trimethoprim Basiliximab N/A (N/A) Administer post-HD (N/A) 10mg/kg TMP IV daily, Administer Administer anytime during HD (SMX/TMP) 1-8mg PO Q24H, post-HD over 30-60 min Minimal 2.5-5mg PO Q24H, Doxazosin Administer anytime during HD; Methyl- 5-20 Normal dose based on indication, N/A (Low Flux) Normal dose based target serum level, Bisoprolol Dose post-HD if hypotensive prednisolone (N/A) Administer post-HD Tacrolimus N/A Administer post-HD Administer anytime during HD <8 6 100mg IV/PO Q12-24H, Normal dose based on blood work, Doxycycline 5mg PO/IV Q6H, Administer anytime 20-80mg PO Q24H, Calcitriol (High & Low (N/A) Administer anytime during HD 2-51 0 Administer anytime during HD Metoclopramide during HD; (if given on HD, may Telmisartan Administer anytime during HD; Dose Flux) (Low Flux) (N/A) 400mg PO Q12H, require supplemental dose post-HD) post-HD if hypotensive Dronedarone N/A Calcium Normal dose based on blood work, Administer anytime during HD 12.5-200mg Q12H, 15-30mg PO HS PRN, Acetate, As phosphate binder, administer Temazepam N/A N/A 38-57 2.5-10mg PO Q24-48H, Metoprolol N/A Administer anytime during HD; Dose Administer anytime during HD Calcium with meals; As supplementation, Enalapril post-HD if hypotensive (Low Flux) Administer post-HD 1-20mg PO QHS, Carbonate administer post-HD Terazosin N/A No 25-45 500mg IV/PO Q 8-12H, Administer anytime during HD 100units/kg/week IV/SC initially, Metronidazole Normal dose based on blood work Epoetin alfa (High & Low (Low Flux) Administer post-HD over 20 minutes Calcium Administer anytime during HD Not recommended; 125mg PO Q24H, and indication, Flux) Terbinafine N/A Gluconate Likely Yes 100-150mg IV Q24H, Administer anytime during HD Administer anytime during HD; 500mg IV Q24H, N/A Infusion 30 Micafungin Dose post-HD if feasible Ertapenem Administer post-HD over 30 Administer anytime during HD 250-500mg PO Q24H, (N/A) Tetracycline N/A minutes Administer anytime during HD 4-32mg PO Q24H, 2.5-10mg PO PRN intradialytic 0 Yes Candesartan Administer anytime during HD; 0-7 250-500mg PO Q12H, Midodrine hypotension, 0 LD 100mg IV, then 50mg IV Q12H, (High Flux) Erythromycin (N/A) Tigecycline Dose post-HD if hypotensive (Low Flux) Administer anytime during HD Administer at the start of HD (N/A) Administer anytime during HD 40 12.5-50mg PO Q24H, 10mg PO Q24H, Likely 2.5-80mg PO in 1-2 divided doses, LD 2mg/kg IV, then MD 1-1.5mg/kg IV Captopril Ezetimibe N/A Minoxidil (High Flux) (N/A) 50 QHD (Once daily dosing NOT Administer post-HD Administer anytime during HD Administer post-HD Tobramycin (Low Flux) recommended), Administer post-HD Normal dose based on indication, AVOID use, Fenofibrate N/A AVOID if possible; Reduce to 50% of (or last 10 minutes of HD) titrate according to target serum Not recommended 23-51 normal dose and titrate, Administer 9 (Low Flux) level; Administer post-HD, if 0.25-2g PO Q24H, start with low dose Carbamazepine Normal dose based on pain Morphine (High & Low post -HD (if given on HD, may 28 (High Flux) feasible.