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21.5

Use of Medicines in Renal DYSFUNCTION/IMPAIRMENT

Malawi Standard Treatment Guidelines, 6th Edition, 2023. Chapter 21, Renal Conditions.

Clinical Description

Note: Take great care when prescribing any medicine and carefully check medicine prescribing information (e.g. in BNF, MNF) regarding use in renal failure/impairment

Usually safe medicines:

  • Doxycycline
  • Erythromycin
  • Penicillin
  • Phenytoin
  • Rifampicin

Use with care in reduceddoses:

  • Amoxycillin
  • Chloramphenicol (avoid in severe impairment)
  • Cotrimoxazole
  • Diazepam
  • Digoxin
  • Insulin
  • Isoniazid-containing medicines
  • Pethidine (increase dose interval, avoid in severe impairment)
  • Phenobarbitone
  • Propranolol
  • Antiretroviral medicines

Avoid using:

  • ACE inhibitors (eg. Captopri)
  • Aspirin and other NSAIDS (eg. Ibuprofen, Indomethacin, diclofenac)
  • Codeine
  • Ethambutol
  • Gentamycin
  • Nalidixic acid
  • Nitrofurantoin
  • Streptomycin

Check doses against the printed guideline and your clinical judgement before treating a patient. Spotted an error? Report it from the contact links below.

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