Palliation and Renal Failure: Common Non-opioid Medication Dosage Guidelines

Abstract In the published literature there is little information on selection of medications, doses and regimes that are safe for symptom control in patients with renal failure or those using dialysis. A literature search was conducted of journal articles on medications, renal failure and dose adjustments from January 1965 to December 2000, and major textbooks of nephrology, anaesthesia and pharmacology were also reviewed. For common palliative medications, relevant available information suggests alterations to both dosage or dosage interval for individuals with renal impairment. For many medications the interaction of renal failure or dialysis is not known, and this may affect choice of medication or the withholding of a medication or lead to toxicity from either the medication itself or a metabolite. These difficulties suggest the need for further development of information about how to allow for renal impairment in the prescribing of palliative medications.