CKD medication

What is tacrolimus? Type of drug: calcineurin inhibitor (previously known as FK506, or ‘FK’) Use: immunosuppressant after kidney transplant; other autoimmune disease Dose: 500 mg – 1 g twice a day (0.1 mg/kg twice a day) Side-effects: Diabetes – 30% of patients Hair loss Liver dysfunction Neurological and/or psychiatric syndromes Monitor: target blood levels 5-10 ng/mL (after […]

What is spironolactone? Type of drug: mineralocorticoid receptor antagonist (MRA) Use: potassium sparing diuretic (water tablet); chronic liver disease; chronic heart failure (CHF) Dose: 25-100 mg once a day Side-effects: Gynaecomastia (breast enlargement in male); abnormal liver function; Hyponatraemia (low blood sodium) – that you will not normally notice Hyperkalaemia (high blood potassium) – that

What is sodium bicarbonate? Type of drug: alkali Use: metabolic acidosis (e.g. of CKD) Dose: 500 mg once a day to 2 g twice a day Side-effects: Fluid retention Alkalosis – that you will not normally notice Hypokalaemia (low blood potassium) – that you will not normally notice Monitor: venous bicarbonate; potassium. Note. This is an alkali tablet.

What is prednisolone? Type of drug: corticosteroid (and synthetic version of cortisol) Use: immunosuppressant after kidney transplant; anti-inflammatory; other autoimmune disease Dose: 5 mg alternate days to 80 mg once a day (for short periods); maintenance dose is 5 mg once a day Side-effects: Diabetes; osteoporosis; increased appetite Cushing’s syndrome: hypertension; moon face; weight gain

What is mycophenolate? Type of drug: purine synthesis blocker (antimetabolite) Use: immunosuppressant used after kidney transplant; other autoimmune disease Dose: 500 mg twice a day Side-effects: Gastrointestinal disorders Liver dysfunction Bone marrow suppression – causing low haemoglobin, white cells and platelets. Monitor: FBC, liver enzymes. Note 1. It is an alternative drug to azathioprine is an

What is ramipril? Type of drug: angiotensin-converting-enzyme inhibitor (ACE) Use: high blood pressure (hypertension); CKD with protein in urine (especially diabetes); congestive (chronic) heart failure (CHF) Dose: 12.5-10 mg once a day Side-effects: Dry cough Hyperkalaemia (high blood potassium level) – that you will not normally notice AKI – mainly in patients with renovascular disease.

What is losartan? Type of drug: angiotensin receptor blocker (ARB) Use: high blood pressure (hypertension); CKD with protein in urine (especially diabetes); chronic heart failure (CHF) Dose: 25-100 mg once a day Side-effects: Hyperkalaemia (high blood potassium level) – that you will not normally notice AKI – mainly in patients with renovascular disease. Monitor: U+E,

What is linagliptin? Type of drug: dipeptidylpeptidase-4 (DPP4) inhibitor (increases insulin secretion) Use: type 2 diabetes Dose: 5 mg once a day (same in CKD) Side-effects: side-effects are uncommon Monitor: glucose, HbA1C. Other resources CKD patient information (CKD Explained’s 30+ core articles about CKD) Linagliptin (BNF) Review article: McGill, 2012

What is hydralazine? Type of drug: BP tablet (vasodilator) Use: high blood pressure (hypertension); chronic heart failure (CHF) Dose: 25 mg twice a day, to 100 mg three times a day Side-effects: hypotension (low BP); lupus-like syndrome; tachycardia (fast heart rate) Monitor: low BP. Other resources CKD drug side-effects CKD patient information (CKD Explained’s 30+ core

What is gabapentin? Type of drug: gamma aminobutyric acid (GABA) analogue Use: itching in CKD; chronic pain; epilepsy Dose: in CKD, start low dose, e.g. 100mg alternate nights Side-effects: confusion, drowsiness Monitor: neuropsychological side-effects. Other resources CKD drug side-effects CKD patient information (CKD Explained’s 30+ core articles about CKD) Gabapentin (BNF) Review article: Yasaei, 2022 Medication