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A new dosing regimen in renal insufficiency: Application to cephalexin
Author(s) -
Hori Ryohei,
Okumura Katsuhiko,
Nihira Hiromi,
Nakano Hiroshi,
Akagi Kazuyoshi,
Kamiya Akira
Publication year - 1985
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1038/clpt.1985.173
Subject(s) - nomogram , renal function , medicine , urology , dosing , urine , creatinine , regimen , pharmacokinetics , pharmacology
We describe a new method of drug dosage adjustment. The method simultaneously considers glomerular and tubular functions as parameters, because nonparallel decreases in both functions limit the use of the conventional endogenous creatinine clearance (CL CR ) method for dosage adjustment. In the new method, CL CR and the 15‐minute phenolsulfonphthalein (PSP15′) test were used and applied to patients with renal insufficiency with cephalexin (CEX) as a model drug for renal tubular secretion. The results clearly demonstrate good control of plasma CEX concentrations by the CL CR ‐PSP15′ method, whereas there were marked changes in plasma CEX levels with the CL CR method alone. Our method appears to be more useful for patients with renal impairment than the conventional CL CR method for CEX, which is mainly excreted in urine by renal tubular secretion. A nomogram for the CEX dosing interval is proposed for application to clinical practice. Clinical Pharmacology and Therapeutics (1985) 38, 290–295; doi: 10.1038/clpt.1985.173