In the setting of rapidly improving/worsening renal function, calculations of eGFR are inaccurate, and dosing should be based on estimated renal function instead.
If worsening renal function, actual GFR is likely lower than calculated.
If improving renal function, actual GFR is likely higher than calculated eGFR.
Not on Dialysis (eGFR) (Maintenance dose following 300 mg IV load)
150 mg IV q48h, or if less than 60 kg, 2.5 mg/kg IV q48h
150 mg IV q24h, or if less than 60 kg, 2.5 mg/kg IV q24h