💊 Drug Dosing in Chronic Kidney Disease

Common medications requiring dose adjustment

Drug	eGFR >60	eGFR 30‑59	eGFR 15‑29	eGFR <15
Metformin	Full dose	Reduce by 50%	Avoid	Avoid
Allopurinol	300 mg/day	200 mg/day	100 mg/day	50‑100 mg/day
Gabapentin	300‑600 mg TID	200‑400 mg BID	200‑300 mg/day	100‑200 mg/day
Pregabalin	150‑300 mg/day	75‑150 mg/day	25‑75 mg/day	25 mg/day
Digoxin	125‑250 mcg/day	125 mcg/day	62.5‑125 mcg alternate days	62.5 mcg alternate days
Lithium	Monitor levels	Reduce dose, monitor	Avoid	Avoid
NSAIDs (ibuprofen, etc.)	Avoid if CKD	Avoid	Avoid	Avoid

⚠️ This is a general guide. Always check specialist references and adjust based on individual patient factors.