GlobalRPh Renal Dosing Masterv6.6
Clinical interpretation | Version 6.6

Find the difference.
Keep the context.

Search documented disagreements and product cautions across the local library. Compare complete source versions on the drug page before choosing a regimen.

A difference is not always a contradiction

Compare indication, formulation, route, population, renal method, dialysis conditions and source date. A safety update or source-quality failure is not an alternative dose. These notes are not independent clinical approval, and sources are not ranked or averaged.

445 matching notes. Showing 65-80; page 5 of 28.

baseline vs toxicity

Carfilzomib injection (KYPROLIS)

New renal toxicity is not a baseline starting-dose table

KYPROLIS renal hold/restart criteria depend on creatinine change, clearance, causality and the selected oncology dose level; HD administration follows dialysis.

What to reconcile

Do not calculate one universal renal maintenance dose or restart from an unrelated oncology regimen. Preserve the causality and recovery conditions.

1 source identities and dates
GlobalRPh RX List - KYPROLIS

GlobalRPh-hosted RX List | Source revision: Source revision date not established in selected retrieval.
Carfilzomib treatment-emergent renal toxicity; dose-level reduction depends on the selected oncology regimen.

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Source-specific interpretation; independent clinician adjudication pending. Added: v4.2.

indication measure and daily dose

Carglumic acid - CARBAGLU tablets for suspension

Total daily doses, indexed eGFR and metabolic indication must stay together

CARBAGLU has separate renal tables for NAGS deficiency and acute PA/MMA-associated hyperammonemia. The numbers are total daily doses, not doses per administration.

What to reconcile

Confirm the indication, indexed eGFR, actual weight/BSA, dose splitting and rounding before prescribing; no ESRD dose is inferred.

1 source identities and dates
Carglumic acid - CARBAGLU tablets for suspension

DailyMed / Recordati Rare Diseases Inc. | Source revision: 1/2024
CARBAGLU 200 mg tablets for suspension. Match NAGS deficiency versus PA/MMA and acute versus chronic hyperammonemia.

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Source-specific interpretation; independent clinician adjudication pending. Added: v5.7.

dialyzability without regimen

Carisoprodol - SOMA oral tablets

Dialyzability does not supply a replacement-dose schedule

The source provides caution and removal information, not a tested renal dosing table.

What to reconcile

Do not invent a supplemental dose or classify the evidence gap as no adjustment.

1 source identities and dates
GlobalRPh RX List - SOMA

GlobalRPh-hosted RX List | Source revision: Source revision date not established in selected retrieval.
SOMA single-ingredient oral carisoprodol; not aspirin- or codeine-containing combinations.

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Source-specific interpretation; independent clinician adjudication pending. Added: v5.8.

within label scope and currency hold

Carmustine - BiCNU intravenous injection

A numeric stop threshold does not cancel a broader restriction

Both retrieved sources retain broad renal non-administration wording alongside a numeric discontinuation threshold. The official document also has conflicting date fields.

What to reconcile

Reconcile the current exact product and oncology protocol; do not manufacture a permissive renal ladder from the threshold.

2 source identities and dates
GlobalRPh RX List - BiCNU

GlobalRPh-hosted RX List | Source revision: Source revision date not established in selected retrieval.
BiCNU carmustine for intravenous infusion; not an intracranial implant. The retrieved label is a dated product snapshot, not proof of current availability.

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BiCNU - carmustine intravenous kit

DailyMed / Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc. | Source revision: Highlights 11/2021; manufacturer text 10/2020; SPL effective 2023-11-21
BiCNU carmustine for intravenous infusion; not an intracranial implant. The retrieved label is a dated product snapshot, not proof of current availability.

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Source-specific interpretation; independent clinician adjudication pending. Added: v5.8.

population specific monitoring

Casimersen - AMONDYS 45 intravenous injection

A creatinine-only dosing shortcut is inappropriate for this evidence

The product requires DMD-specific renal surveillance rather than a validated creatinine-based reduction table.

What to reconcile

Use the dated monitoring card, including urine-collection timing and assay interference precautions; do not infer a renal dose.

2 source identities and dates
GlobalRPh RX List - AMONDYS 45

GlobalRPh-hosted RX List | Source revision: Source revision date not established in selected retrieval.
AMONDYS 45 intravenous casimersen in Duchenne muscular dystrophy with an exon-45-skipping-amenable mutation; renal monitoring is not a creatinine-only dose table.

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AMONDYS 45 - casimersen injection

DailyMed / Sarepta Therapeutics, Inc. | Source revision: 1/2026
AMONDYS 45 intravenous casimersen in Duchenne muscular dystrophy with an exon-45-skipping-amenable mutation; renal monitoring is not a creatinine-only dose table.

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Source-specific interpretation; independent clinician adjudication pending. Added: v5.8.

metric and dialysis evidence gap

Cefditoren pivoxil - SPECTRACEF oral tablets

Printed indexed CrCl and undefined ESRD dosing need separate checks

The source uses indexed clearance units and reports dialysis removal without an established ESRD regimen.

What to reconcile

Do not silently relabel the units or extrapolate a dialysis dose; official-product reconciliation remains pending.

1 source identities and dates
GlobalRPh RX List - SPECTRACEF

GlobalRPh-hosted RX List | Source revision: Source revision date not established in selected retrieval.
SPECTRACEF oral cefditoren pivoxil; selected historical product guidance, not proof of current US commercial availability.

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Source-specific interpretation; independent clinician adjudication pending. Added: v5.8.

dialysis setting

Cefepime

Daily post-HD timing is not the same as post-HD-only dosing

Label and institutional sources include daily dosing and post-dialysis-only schedules. Their indication, dialysis frequency, infusion, and exposure assumptions differ.

What to reconcile

Select one complete locally approved regimen; do not add a daily dose on top of a post-HD-only schedule.

3 source identities and dates
GlobalRPh RX List - Maxipime

GlobalRPh-hosted RX List | Source revision: Revision date not established in selected retrieval.
Adult IV cefepime. Columns below correspond to the original usual regimen, not interchangeable infection choices.

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UCSF - cefepime: short infusion and dialysis

UCSF Infectious Diseases Management Program | Source revision: Revision date not stated in the reviewed page.
Adult IV cefepime; short infusion, selected extended infusion, IHD and CVVHD.

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Stanford - cefepime dialysis strategies

Stanford Health Care Antimicrobial Safety and Sustainability | Source revision: Current retrieved guide; see source document for revision history.
Adults; cefepime IV. Guide page 2, IHD/CRRT columns.

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Source difference identified; final patient-specific adjudication required. Added: vearlier.

institutional versus label dialysis strategy

Cefepime

Different HD schedules remain source-specific, not interchangeable

The MAXIPIME mirror uses daily maintenance; UCSF describes a post-HD strategy and a separate unstable-schedule alternative.

What to reconcile

Resolve indication, dialysis timing and local specialist protocol before selecting a regimen; do not average or mix schedules.

2 source identities and dates
GlobalRPh RX List - MAXIPIME

GlobalRPh-hosted RX List | Source revision: Source revision date not established in selected retrieval.
Single-agent intravenous cefepime in adults. Label-mirror schedules and UCSF institutional regimens must retain their distinct context.

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UCSF cefepime - dated institutional recheck

UCSF Infectious Diseases Management Program | Source revision: Source revision date not established in selected retrieval.
Single-agent intravenous cefepime in adults. Label-mirror schedules and UCSF institutional regimens must retain their distinct context.

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Source-specific interpretation; independent clinician adjudication pending. Added: v5.8.

selected concordance and crrt scope

Cefiderocol (Fetroja)

CRRT effluent guidance is not an intermittent-HD dose table

The selected official and mirror tables agree. Their CRRT guidance is explicitly initial and depends on effluent rather than a CrCl band.

What to reconcile

Confirm modality and L/hour effluent, then reassess residual function and clinical status; do not interpolate a new algorithm.

2 source identities and dates
GlobalRPh RX List - FETROJA

GlobalRPh-hosted RX List | Source revision: Source revision date not established in selected retrieval.
FETROJA intravenous cefiderocol in adults; renal function, intermittent HD and CRRT effluent are separate dosing contexts.

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FETROJA - cefiderocol intravenous injection

DailyMed / Shionogi Inc. | Source revision: 3/2026 (printed highlights); DailyMed updated 2026-02-24
FETROJA intravenous cefiderocol in adults; renal function, intermittent HD and CRRT effluent are separate dosing contexts.

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Source-specific interpretation; independent clinician adjudication pending. Added: v5.8.

numeric boundary disagreement

Cefiderocol (Fetroja)

The recovered institutional page has different printed boundaries

The official label uses CrCl >=120; UCSF prints >120 beside 60-119. The upper effluent band is >=4.1 L/hour in the label versus >4 in UCSF.

What to reconcile

For exactly CrCl 120 the official label is explicit. Preserve the institutional discrepancy and seek clarification for effluent values between printed bands; do not interpolate. This is a wording/boundary comparison, not evidence of different clinical outcomes.

2 source identities and dates
Cefiderocol - FETROJA adult intravenous therapy

DailyMed / Shionogi Inc. | Source revision: 3/2026 (highlights); DailyMed updated 2026-02-24
Adult cefiderocol IV; distinguish non-dialysis CrCl from intermittent HD and CRRT effluent. Institutional protocols remain separately attributed.

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UCSF cefiderocol - fresh institutional follow-up

UCSF Infectious Diseases Management Program | Source revision: Source revision date not established in selected retrieval.
Adult cefiderocol IV; distinguish non-dialysis CrCl from intermittent HD and CRRT effluent. Institutional protocols remain separately attributed.

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Source-specific interpretation; independent clinician adjudication pending. Added: v5.9.

administration

Ceftolozane / tazobactam (Zerbaxa)

One-hour labeling versus institutional extended infusion

The RX label table uses a one-hour infusion. The UCSF protocol uses a three-hour infusion. Both also separate urinary/intra-abdominal infection from pneumonia/severe infection.

What to reconcile

Keep the selected source dose, indication, renal band, loading instruction and infusion duration together.

2 source identities and dates
GlobalRPh RX List - Zerbaxa

GlobalRPh-hosted RX List | Source revision: Revision date not established in selected retrieval.
Adult IV combined doses; cUTI/cIAI and HABP/VABP columns remain separate.

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UCSF - ZERBAXA: urinary versus severe infection

UCSF Infectious Diseases Management Program | Source revision: Revision date not stated in the reviewed page.
Adults; ceftolozane/tazobactam total combination doses IV; ID/stewardship restricted.

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Source difference identified; final patient-specific adjudication required. Added: vearlier.

label version update

Ceftolozane / tazobactam (Zerbaxa)

Pediatric renal guidance changed after the RX mirror

The older mirror lacks the age-specific renal regimens now supplied by the May 2026 label.

What to reconcile

Use the new pediatric card for ages two and older; verify indication, pediatric eGFR, weight caps and infusion time. Do not use adult Cockcroft-Gault bands as pediatric instructions.

2 source identities and dates
GlobalRPh RX List - ZERBAXA

GlobalRPh-hosted RX List | Source revision: May 2022
Adult IV ZERBAXA only in this older mirror; pediatric guidance is in the separate 2026 label card.

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ZERBAXA - May 2026 pediatric renal regimens

DailyMed / Merck Sharp & Dohme LLC | Source revision: May 2026
Pediatric ZERBAXA age 2 to below 18 with renal impairment; May 2026 label, Table 4. Doses are total ceftolozane+tazobactam.

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Source-specific interpretation; independent clinician adjudication pending. Added: v3.7.

setting specific

Cephalexin

Label maximum differs from institution-specific bacteremia dosing

The KEFLEX renal table caps the daily dose in moderate impairment. UCSF uses a different high-dose strategy for selected gram-negative bloodstream infection; Stanford also has a distinct HD regimen.

What to reconcile

The indication and regimen must stay together. Do not average the doses or relabel the bloodstream-infection schedule as a general renal dose.

3 source identities and dates
GlobalRPh RX List - Keflex

GlobalRPh-hosted RX List | Source revision: Revised October 2015
Adults and patients at least 15 years old; oral cephalexin label table.

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UCSF - cephalexin: bacteremia and IHD

UCSF Infectious Diseases Management Program | Source revision: Revision date not stated in the reviewed page.
Adults; source-specific institutional guidance. Match route, indication and renal replacement modality.

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Stanford - cephalexin selected renal/HD rows

Stanford Health Care | Source revision: ABX Subcommittee approved February 2026 (cover page visually inspected)
Adult oral cephalexin; selected rows from institutional antimicrobial guide.

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Source difference identified; final patient-specific adjudication required. Added: vearlier.

professional protocol difference

Cephalexin

Label daily cap versus indication-specific institutional bloodstream doses

KEFLEX limits total daily dose to 1 g at CrCl 30-59 and has insufficient HD adjustment information. UCSF uses higher selected Gram-negative bloodstream-infection doses and supplies an intermittent-HD row.

What to reconcile

Assess infection eligibility, organism susceptibility, patient setting and institutional policy. Keep the complete institutional regimen separate from the label; do not transfer the bloodstream schedule to routine cystitis or children.

2 source identities and dates
GlobalRPh RX List - KEFLEX

GlobalRPh-hosted RX List | Source revision: Source revision date not established in selected retrieval.
Oral KEFLEX; renal table applies to adults and pediatric patients at least 15 years old.

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UCSF cephalexin - selected bloodstream-infection and dialysis rows

UCSF Infectious Diseases Management Program | Source revision: Source revision date not established in selected retrieval.
Adult institutional oral therapy for selected gram-negative bloodstream infection; eligibility not established by the renal table alone.

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Source-specific interpretation; independent clinician adjudication pending. Added: v4.2.

formulation and population

Cetirizine injection (QUZYTTIR)

IV cetirizine is not the oral levocetirizine renal schedule

The selected QUZYTTIR IV label does not require a renal dose change in the stated populations, but use below age 6 with renal or hepatic impairment is not recommended. Oral levocetirizine has a separate renal schedule and exclusions.

What to reconcile

Match the ingredient, route, age and acute-urticaria indication. Do not transfer an oral schedule to this IV product or turn a pediatric not-recommended statement into an adult contraindication.

1 source identities and dates
QUZYTTIR - IV cetirizine, renal and age-specific instructions

DailyMed | Source revision: March 2026
QUZYTTIR IV cetirizine for acute urticaria. Renal guidance applies with the explicit under-6-year exclusion.

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Source-specific interpretation; independent clinician adjudication pending. Added: v3.5.

absence of data not no adjustment

Cevimeline - EVOXAC oral capsules

Unstudied renal PK must not appear as no adjustment needed

The official and mirror sections agree on an evidence gap, not on an established CKD regimen.

What to reconcile

Keep renal and dialysis uncertainty visible, with stone and hydration precautions.

2 source identities and dates
GlobalRPh RX List - EVOXAC

GlobalRPh-hosted RX List | Source revision: Source revision date not established in selected retrieval.
EVOXAC oral cevimeline capsules for dry-mouth symptoms in Sjogren syndrome; kidney-stone precautions and renal PK gaps are distinct.

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EVOXAC - cevimeline hydrochloride capsules

DailyMed / Cosette Pharmaceuticals, Inc. | Source revision: Issued 02/2022; DailyMed updated 2022-09-07
EVOXAC oral cevimeline capsules for dry-mouth symptoms in Sjogren syndrome; kidney-stone precautions and renal PK gaps are distinct.

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Source-specific interpretation; independent clinician adjudication pending. Added: v5.8.

What is not established by this directory

Only documented issues are searchable here. Absence of a note is not agreement. A label mirror and the original label are not independent corroboration, and a source's retrieval date is not its revision date.

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