>25 Dose as in normal renal function 15–25 Dose as in normal renal function <15 Dose as in normal renal function
DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES
CAPD                : Not dialysed. Dose as in normal renal function
HD                     : Dialysed. Dose as in normal renal function
HDF/high flux   : Dialysed. Dose as in normal renal function
CAV/VVHD      : Probably dialysed. Dose as in normal renal function
IMPORTANT DRUG INTERACTIONS
Potentially hazardous interactions with other drugs
Anti-arrhythmics: increased risk of ventricular arrhythmias with amiodarone – avoid concomitant use; concentration of procainamide increased
Anti-epileptics: antifolate effect and concentration of phenytoin increased
Antimalarials: increased risk of antifolate effect with pyrimethamine
Ciclosporin: increased risk of nephrotoxicity Cytotoxics: increased risk of haematological toxicity with azathioprine and mercaptopurine; antifolate effect of methotrexate increased
ADMINISTRATION
Reconstition
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Route
Oral
Rate of Administration
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Comments
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OTHER INFORMATION
Serum creatinine may rise due to competition for renal secretion Hyperkalaemia is common in CKD 5 Short-term folic acid supplementation may be prescribed in patients with CKD 4-5 to cover antifolate effects of treatment dose .