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Clinical context remains essential
Independent clinical review is pending. Confirm indication, exact formulation/route, population, renal measure and units, kidney-function stability, dialysis prescription, interacting drugs, monitoring and source revision. An RX mirror and its original label are not independent corroboration. Missing disagreement notes do not certify agreement.
The original renal band is printed as >51-80 and the reduced dose as 950 mg/m2. These values are preserved as source text, not recalculated or silently corrected.
Indexed eGFR, mL/min/1.73 m2; not Cockcroft-Gault CrCl.
Source revision
Retrieved September 7, 2026; renal deviation explicitly attributed to RCM consensus 2023.
Retrieved
2026-09-07
Local review status
Selected source text imported locally; independent clinical review pending. Not a complete prescribing monograph.
Documented differences and cautions on this drug
All record notes are retained here, including notes about sources not selected in this review.
eviQ protocols disagree at the same indexed eGFR band
At eGFR 45-59 mL/min/1.73 m2, metastatic colorectal protocol 94 considers a 25% reduction or an alternative, whereas post-neoadjuvant breast protocol 3503 permits full dose with increased adverse-event risk. Protocol 94 explicitly identifies a committee-endorsed departure from ADDIKD.
What to reconcile: Choose by the exact cancer setting and protocol, not whichever dose is larger or smaller. These are two protocols from one organization, not independent confirmation. Record the indication, protocol number, renal metric and oncology rationale.
The newly imported RX label specifies Cockcroft-Gault CrCl; the eviQ tables use indexed eGFR. Similar numbers do not establish equivalent renal categories. The newer RX text says a dose below CrCl 30 is not established, unlike the older preserved source restriction.
What to reconcile: Read the original and newer source in full. Do not convert a missing established dose into permission to use a regimen or substitute eGFR for CrCl without reconciling the method. A retrieval date alone does not establish a label version.
Current label renal wording and DPYD testing need a dated reading
The retrieved 2026 official labels state that a dosage below Cockcroft-Gault CrCl 30 is not established, whereas the older generic RX mirror calls this range contraindicated. Current labels also include pretreatment DPYD testing precautions.
What to reconcile: Use the exact current product label and oncology protocol; do not interpret absence of an established dose as permission. Older eviQ comparisons were not rechecked in this pass.
eviQ / Cancer Institute NSW · eviQ protocol 94, adult metastatic colorectal capecitabine; protocol-specific kidney modification.
Renal method: Indexed eGFR, mL/min/1.73 m2; not Cockcroft-Gault CrCl. Source date: Retrieved September 7, 2026; renal deviation explicitly attributed to RCM consensus 2023. Retrieved: 2026-09-07
Dose or interval guidance. Use only the product, indication, renal metric and population described in this source.
Selected source text imported locally; independent clinical review pending. Not a complete prescribing monograph.
Renal dosing, restrictions and evidence limits
For this metastatic colorectal protocol, indexed eGFR >=60 mL/min/1.73 m2 permits the protocol's full dose. At 45-59, consider a 25% reduction or an alternative protocol; the page explicitly identifies this as a 2023 reference-committee deviation from ADDIKD. At 30-44, consider a 25% reduction or an alternative protocol. At 15-29 or below 15 without kidney replacement therapy, avoid this protocol and use an alternative. Increased toxicity risk is flagged in the intermediate bands. Dialysis requires multidisciplinary oncology, nephrology and/or clinical pharmacology input. These are protocol-specific Australian recommendations, not a substitute for U.S. labeling.
This reference does not select a regimen. Complete the indication, measured/estimated renal function and trend, dialysis setting, source rationale, monitoring and reassessment plan in your institution's approved documentation system. Confirm the complete current source before adopting its regimen.
GlobalRPh v6.6 | RDM66-DIRECT-PHP-20260911 | Local library date 2026-09-11. Selected-card identity does not imply clinical verification.