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

for Health Care Providers

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

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DrugStandard DosageAdjusted Dosage/Notes
Adapted from McNicholl IR, Rodriguez RA. Dosing of Antiretroviral Drugs in Adults with Renal Insufficiency and HemodialysisLink will take you outside the VA website. VA is not responsible for the content of the linked site.. San Francisco: University of California San Francisco, Center for HIV Information; 2010. Accessed April 1, 2011.
ABC300 mg PO BIDDosage adjustment for renal insufficiency does not appear necessary
ddI250-400 mg PO QD, depending on weightCrCl (mL/min)Weight ≥60 kgWeight <60 kg
≥60400 mg QD250 mg QD
30-59200 mg QD125 mg QD
10-29125 mg QD125 mg QD
<10125 mg QDformulation not suitable
Hemodialysis125 mg QDformulation not suitable
FTC200 mg PO QDCrCl (mL/min)
≥50200 mg QD
30-49200 mg Q48H
15-29200 mg Q72H
<15200 mg Q96H
Hemodialysis200 mg Q96H, give after dialysis
3TC150 mg PO BID or 300 mg PO QDCrCl (mL/min)
≥50150 mg BID or 300 mg QD
30-49150 mg QD
15-29150 mg first dose, then 100 mg QD
5-14150 mg first dose, then 50 mg QD
<550 mg first dose, then 25 mg QD
d4T20 mg to 40 mg PO BID, depending on weightCrCl (mL/min)Weight ≥60 kgWeight <60 kg
>5040 mg BID30 mg BID
26-5020 mg BID15 mg BID
10-2520 mg QD15 mg QD
Hemodialysis20 mg QD15 mg QD
TDF300 mg PO QDExperience in patients with CrCl <60 mL/min is limited. Preliminary data suggest:
CrCl (mL/min)
≥50300 mg QD
30-49300 mg Q48H
10-29300 mg twice weekly
Hemodialysis300 mg weekly
ZDV300 mg PO BIDCrCl (mL/min)
<15100 mg Q6-8H
Hemodialysis100 mg TID

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