Drug CategoryDrugIHD Dosing

Administration Timing Around HD Session

Antibiotics Metronidazole 500mg IV/PO Q8-12H Administer Post-HD

Molecular Weight    (Da)

Excreted Unchanged (%)Normal Half-Life (Hours)ESRD Half-Life (Hours)Plasma Protein Binding (%)Volume of Distribution (L/kg)Dialytic Plasma Clearance (ml/min)% Dialyzed
171 20 6-14 7-21 20 0.25-0.85 60-125 25-44.9 (low flux)


  • Aronoff GR, Bennett WM, Berns JS, Brier ME, Kasbekar N, Mueller BA, et al. Drug Prescribing in Renal Failure. Philadelphia: American College of Physicians;2007.
  • DrugBank [Online]. 2012 Apr 12 [cited 2012 May 6]; Available from: URL:
  • Heintz B, Matzke G, Dager W. Antimicrobial dosing concepts and recommendations for critically ill adult patients receiving continuous renal replacement therapy or intermittent hemodialysis. Pharmacotherapy 2009; 29(5), 562-77.
  • Lamp K, Freeman C, Klutman N, Lacy M. Pharmacokinetics and pharmacodynamics of the nitroimidazole antimicrobials. Clinical pharmacokinetics 1999; 36(5), 353-73.
  • Lau A, Chang C, Sabatinit S. Hemodialysis Clearance of Metronidazole and Its Metabolites. Antimicrobial agents and chemotherapy 1986; 29(2), 235-8.
  • Makowsky M, Warkentin D, Savoie M. Caspofungin and amphotericin B for disseminated Fusarium verticillioides in leukemia. The Annals of pharmacotherapy 2005; 39(7-8), 1365-6.
  • Matzke G. Status of Hemodialysis of Drugs in 2002. Journal of Pharmacy Practice 2002; 15(5), 405-418.
  • Roux A, Moirot E, Delhotal B et al. Metronidazole kinetics in patients with acute renal failure on dialysis: A cumulative study. Clinical pharmacology and therapeutics 1984; 363-368.
  • Somogyi A, Kong C, Sabto J, Gurr F, Spicer W, McLean A. Disposition and removal of metronidazole in patients undergoing haemodialysis. European journal of clinical pharmacology 1983; 25(5), 683-7.