for Health Care Providers

Table 2. NRTI Dosing for Patients with Decreased Renal Function (based on CrCl)

Drug	Standard Dosage	Adjusted Dosage/Notes
Adapted from McNicholl IR, Rodriguez RA. Dosing of Antiretroviral Drugs in Adults with Renal Insufficiency and Hemodialysis. San Francisco: University of California San Francisco, Center for HIV Information; 2010. Accessed April 1, 2011.
ABC	300 mg PO BID	Dosage adjustment for renal insufficiency does not appear necessary
ddI	250-400 mg PO QD, depending on weight	CrCl (mL/min)	Weight ≥60 kg	Weight <60 kg
		≥60	400 mg QD	250 mg QD
		30-59	200 mg QD	125 mg QD
		10-29	125 mg QD	125 mg QD
		<10	125 mg QD	formulation not suitable
		Hemodialysis	125 mg QD	formulation not suitable
FTC	200 mg PO QD	CrCl (mL/min)
		≥50	200 mg QD
		30-49	200 mg Q48H
		15-29	200 mg Q72H
		<15	200 mg Q96H
		Hemodialysis	200 mg Q96H, give after dialysis
3TC	150 mg PO BID or 300 mg PO QD	CrCl (mL/min)
		≥50	150 mg BID or 300 mg QD
		30-49	150 mg QD
		15-29	150 mg first dose, then 100 mg QD
		5-14	150 mg first dose, then 50 mg QD
		<5	50 mg first dose, then 25 mg QD
d4T	20 mg to 40 mg PO BID, depending on weight	CrCl (mL/min)	Weight ≥60 kg	Weight <60 kg
		>50	40 mg BID	30 mg BID
		26-50	20 mg BID	15 mg BID
		10-25	20 mg QD	15 mg QD
		Hemodialysis	20 mg QD	15 mg QD
TDF	300 mg PO QD	Experience in patients with CrCl <60 mL/min is limited. Preliminary data suggest:
		CrCl (mL/min)
		≥50	300 mg QD
		30-49	300 mg Q48H
		10-29	300 mg twice weekly
		Hemodialysis	300 mg weekly
ZDV	300 mg PO BID	CrCl (mL/min)
		<15	100 mg Q6-8H
		Hemodialysis	100 mg TID

From Renal Disease
Primary Care of Veterans with HIV
Office of Clinical Public Health Programs
Veterans Health Administration, 2009