DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugsAnalgesics: increased risk of bleeding with aspirin and NSAIDs; risk of CNS toxicity increased with tramadolAnticoagulants: effect of coumarins possibly enhancedAntidepressants: avoid concomitant use with MAOIs and moclobemide, increased risk of toxicity; avoid concomitant use with St John’s wort; possibly enhanced serotonergic effects with duloxetine; can increase tricyclics antidepressant concentration; increased agitation and nausea with tryptophanAnti-epileptics: convulsive threshold loweredAntimalarials: avoid concomitant use with artemether/lumefantrineAntipsychotics: possibly increased clozapine concentrationAntivirals: concentration possibly increased by ritonavirDopaminergics: use selegiline with caution; increased risk of CNS toxicity with rasagiline5 HT 1 agonist: increased risk of CNS toxicity with sumatriptan; possibly increased risk of serotonergic effects with frovatriptanLinezolid: use with care, possibly increased risk of side effectsLithium: increased risk of CNS effects Sibutramine: increased risk of CNS toxicity (avoid concomitant use)

ADMINISTRATION

Reconstition

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Route

Oral

Rate of Administration

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Comments

OTHER INFORMATION

Only 1% of drug is removed by haemodialysisThere is reduced clearance of Citalopram in severe renal failure