Not On Dialysis
CrCl >50 mL/min: 500mg IV/PO q24hr
CrCl 20-50 mL/min: 500mg IV/PO q48hr
CrCl <20 mL/min: 500mg IV/PO q48hr
CrCl >50 mL/min: 750mg IV/PO q24hr
CrCl 20-50 mL/min: 750mg IV/PO q48hr
CrCl <20 mL/min: 750mg IV/PO x 1, then 500mg IV/PO q48hr
Intermittent Hemodialysis (IHD)/Continuous Ambulatory Peritoneal Dialysis (CAPD)
500mg IV/PO q48hr (dose in PM for HD)
750mg IV/PO x 1, then 500mg IV/PO q48hr (dose in PM for HD)
Continuous Renal Replacement Dosing
750mg PO/IV x1, then 500mg IV/PO q24h