Renal failure

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Reduce Assay levels

Use liposomal or colloidal forms, no change

Reduce

Monitor liver function

Reduce if renal and liver failure

Reduce if renal and liver failure

Reduce

Monitor liver function

Caution hepatitis

Reduce Avoid Avoid Reduce

Avoid Avoid

Avoid Avoid

Hepatic failure

Avoid Avoid

CH, continuous hemofiltration; IV, intravenous; IM, intramuscular. Adapted from Cotterill (1995).

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