Drug CategoryDrugIHD Dosing

Administration Timing Around HD Session

Antibiotics Sulfamethoxazole/Trimethoprim Not recommended; if used, 800/160mg PO or 2.5-10mg/kg Trimethoprim IV daily 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
253/290 70/60-80 10/9-13 20-50/20-49 50/30-70 0.28-0.38/1.0-2.2 42/38  57/44 (N/A)


  • 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.
  • Cantaluppi A, Graziani G, Ponticelli C et al. Pharmacokinetic study of the new sulfamethopyrazine-trimethoprim combination (kelfiprim) in renal insufficiency. European journal of clinical pharmacology 1984; 27(3), 345-8.
  • Craig W, Kunin C. Trimethoprim-sulfamethoxazole: pharmacodynamic effects of urinary pH and impaired renal function. Studies in humans. Annals of internal medicine 1973; 78(4), 491-7.
  • Curkovic I, Lüthi B, Franzen D, Ceschi A, Rudiger A, Corti N. Trimethoprim/Sulfamethoxazole pharmacokinetics in two patients undergoing continuous venovenous hemodiafiltration. The Annals of pharmacotherapy 2010; 44(10), 1669-72.
  • 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.
  • Kawamura T, Yagi N, Sugawara H, Yamahata K, Takada M. Efficacy of Hemodialysis and the Effects of Certain Displacing Agents on Plasma Protein Binding of Sulfamethoxazole and Sulfaphenazole in Patients with Chronic Renal Failure. Chem. Pharm. Bull. 1980; 28(1), 268-76.
  • Matzke G. Status of Hemodialysis of Drugs in 2002. Journal of Pharmacy Practice 2002; 15(5), 405-418.