Appropriate prescribing in the elderly: Current perspectives

Table 3 Common used drug classes which require dose adjustment with chronic kidney disease

Drug class	Adjust dose in CKD stage 1-3	Avoid in CKD stages 4 and 5
ACE-inhibitors and Angiotensin 2 receptor blockers	All ACE inhibitors	Olmesartan
Diuretics	Potassium-sparing and thiazide diuretics	Potassium-sparing and thiazide diuretics
Beta-blockers	Acebutolol, atenolol, bisoprolol, nadolol, sotalol	Sotalol
Lipid lowering agents	Pravastatin, rosuvastatin, fibrates	Glyburide, metformin, exanitide
Hypoglycaemic agents	Gliclazide, acarbose, insulin, gliptins
Analgesia (NSAIDs and opioids)	Codeine, tramadol, morphine, oxycodone,	All NSAIDs, pethidine
Psychotropic agents	Lithium, gabapentin, pregabalin, topiramate, vigabatrin, bupropion, duloxetine, paroxetine, venlafaxine
Miscellaneous	Allopurinol, colchicine, digoxin	Dabigatran Rivaroxaban (CI stage 5, dose adjust in stage 4 CKD) Apixaban (CI stage 5, dose adjust in stage 4)

CKD: Chronic kidney disease; ACE-inhibitors: Angiotensin-converting-enzyme inhibitor; NSAIDs: Non-Steroidal anti-inflammatory drugs; CI: Contraindicated.