CLINICAL USE

Antibacterial agent

DOSE IN NORMAL RENAL FUNCTION

600–900 mg every 6 hours

PHARMACOKINETICS

  • Molecular weight                           :232.2
  • %Protein binding                           :93–97
  • %Excreted unchanged in urine     : 11–33 (80–90% as inactive metabolites)
  • Volume of distribution (L/kg)       :0.47–0.55
  • half-life – normal/ESRD (hrs)      :6–8/21

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50     : Dose as in normal renal function
  • 10 to 20     : Dose as in normal renal function
  • <10           : Avoid. See ‘Other Information’

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD                :Unlikely to be dialysed. Dose as in GFR <10 mL/min
  • HD                     :Unlikely to be dialysed. Dose as in GFR <10 mL/min
  • HDF/high flux   :Unlikely to be dialysed. Dose as in GFR <10 mL/min
  • CAV/VVHD      :Unknown dialysability. Dose as in normal renal function

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugs

  • Analgesics: increased risk of convulsions with NSAIDs
  • Anticoagulants: anticoagulant effect of coumarins enhanced
  • Ciclosporin: increased risk of nephrotoxicity
  • Antimalarials: manufacturer of artemether with lumefantrine advises avoid concomitant useTheophylline: possibly increased risk of convulsions

    ADMINISTRATION

    Reconstition

    –

    Route

    Oral

    Rate of Administration

    –

    Comments

    –

    OTHER INFORMATION

    Avoid in severe renal impairment because the concentration in the urine is inadequate, and risk of monoglucuronide metabolite toxicity.

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