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Q:  BP Meds & Dialysis

How can we know for sure how much of my wifes meds are being dialized out during dialysis. 10 mg zyprexa    2000 mg depakote   50 mg lamictal   150 mg of effexor xr.  she is now depressed and seeing our Dr. in the morning. she was hospitalized at Emory in Atlanta for 29 days then home for 2 weeks then back in for 5 days. On dialysis for 3 months. Any words will be helpful.

Dear Mr. B' -- 
The dialysis doc' should be able to answer that question.  Let's see if I can find anything in the literature that might help you.  There is a book about changing drug dosing for people with kidney problems by Aranoff and colleagues called Drug Prescribing in Renal Failure (here's the
Amazon link); they make available their drug tables for physicians at this link (make sure you read that disclaimer there).  Mind you, I'm anything but a renal specialist.  But having the tables handy might facilitate your discussions with her doctors. 

Notice that one of the variables is how your wife's kidneys are functioning.  The tables in Aranoff's book are set up based on that.  So that will be an important thing to know about.  Note also that they're talking about kidney function, not dialysis, in terms of how doses need to be changed.  But that will be an important variable to be understood, as well as what the dialysis process does to medication levels.  Good luck with that. 

Dr. Phelps

Published January, 2005


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