It is best to follow a stepwise process for dosage modification in renal failure. The method outlined here will help clinicians achieve a desirable clinical response while minimizing the risk of adverse drug reactions and toxicity ( Bennett. eLaL 1994). Start dosage modification by (1) assessing renal function by measuring or estimating creatinine clearance, (2) choosing a loading dose, (3) choosing a maintenance dose, and (4) performing therapeutic drug monitoring.
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