Dialyzable drugs

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Background

Factors Influencing Dialyzability

Molecular weight

  • Smaller molecular weight substances will pass through the dialysis membrane more easily than larger molecular weights.

Protein Binding

  • Drugs with a high degree of protein binding will have a small plasma concentration of unbound drug available for dialysis, making them poorly dialyzable or requiring multiple sessions.

Volume of Distribution

  • Drugs with large volumes of distribution usually due to lipid solubility and low plasma protein binding are poorly diliazable.

Plasma clearance

  • Although plasma clearance may be beneficial, increasing plasma clearance will dcrease dialysis clearance.

Dialysis Flow Rates

  • Greater degrees of dialysis can be achieved with faster dialysate flow rates if the dialysate drug concentrations is low. As the concentration of drug is increased in the diasylate the flow rate needs to be lowered.

Common Dialyzable Drugs

Complete dializable drug list[1]

Drug Name Conventional Dialysis High Permeability Peritoneal Dialysis
Amiloride ND ND ND
Aminocaproic acid Yes ND Yes
Aminoglutethimide Yes L ND
Aminosalicylic acid Yes L ND
Amiodarone No ND No
Amitriptyline No ND No
Amlodipine No ND No
Amoxapine U ND U
Amoxicillin Yes L No
Amphotericin B No ND No
Ampicillin Yes L No
Amprenavir U ND ND
Amrinone U ND No
Anagrelide ND ND ND
Anastrozole ND ND ND
Anistreplase U ND U
Antithymocyte globulin ATG U ND U
Aprotinin U ND U
Arbutamine ND ND ND
Ardeparin No ND ND
Asparaginase U ND U
Aspirin Yes L Yes
Atenolol Yes L No
Atorvastatin U ND U
Atovaquone U ND U
Atracurium U ND U
Atropine No ND ND
Auranofin No ND ND
Azathioprine Yes L ND
Azithromycin ND ND ND
Azlocillin Yes L No
Aztreonam Yes L No
Baclofen ND ND ND
Basiliximab U ND U
Benazepril (benazeprilat) No ND ND
Benzquinamide U ND NA
Bepridil No ND U
Betamethasone ND ND ND
Betaxolol No ND No
Bethanechol ND ND ND
Bezafibrate No ND No
Biapenem Yes L ND
Bicalutamide U ND U
Bisoprolol No ND ND
Bleomycin No ND No
Bretylium Yes L ND
Bromfenac No ND U
Bromocriptine U ND U
Buflomedil No No U
Bumetanide No ND U
Bupropion No ND No
Buspirone No ND ND
Busulfan ND ND ND
Butalbital ND ND ND
Butorphanol U ND U
Caffeine ND ND ND
Calcitriol No No U
Candesartan No ND ND
Capecitabine ND ND ND
Capreomycin Yes L ND
Captopril Yes L No
Carbamazepine No ND No
Carbenicillin Yes L No
Carbidopa/levodopa ND ND ND
Carboplatin Yes L ND
Carboprost ND ND ND
Carisoprodol Yes L Yes
Carmustine No ND ND
Carnitine Yes L ND
Carprofen U ND U
Carteolol ND ND ND
Carumonam Yes L ND
Carvedilol No ND ND
Cefaclor Yes L Yes
Cefadroxil Yes L No
Cefamandole Yes L No
Cefazolin Yes L No
Cefdinir Yes L ND
Cefepime Yes L Yes
Cefixime No ND No
Cefmenoxime Yes L ND
Cefmetazole Yes L No
Cefodizime No ND No
Cefonicid No ND No
Cefoperazone No ND No
Ceforanide Yes L No
Cefotaxime Yes L No
Cefotetan Yes L Yes
Cefoxitin Yes L No
Cefpirome Yes Yes No
Cefpodoxime Yes L No
Cefprozil Yes L ND
Cefroxadine ND ND ND
Cefsulodin Yes L Yes
Ceftazidime Yes L Yes
Ceftibuten Yes L ND
Ceftizoxime Yes L No
Ceftriaxone No ND No
Cefuroxime Yes L No
Celecoxib U ND U
Cephalexin Yes L No
Cephalothin Yes L No
Cephapirin Yes L No
Cephradine Yes L Yes
Cerivastatin U ND U
Cetirizine No ND U
Chloral Hydrate Yes L ND
Chlorambucil No ND No
Chloramphenicol Yes L No
Chlordiazepoxide No ND U
Chloroquine No ND No
Chlorpheniramine Yes L No
Chlorpromazine No ND No
Chlorpropamide No ND No
Chlorprothixene U ND U
Chlorthalidone No ND U
Cidofovir ND Yes No
Cilastatin Yes L ND
Cilazapril Yes L ND
Cilostazol U ND U
Cimetidine No ND No
Cinoxacin No ND U
Ciprofloxacin No ND No
Cisapride No ND U
Cisatracurium U ND U
Cisplatin No ND ND
Citalopram U ND U
Cladribine ND ND ND
Clarithromycin ND ND ND
Clavulanic acid Yes ND Yes
Clemastine ND ND ND
Clindamycin No ND No
Clodronate Yes ND No
Clofazimine No ND No
Clofibrate No ND No
Clomipramine U ND U
Clonazepam No ND U
Clonidine No ND No
Clopidogrel U ND U
Clorazepate No ND U
Cloxacillin No ND No
Clozapine U ND U
Codeine No ND U
Colchicine No ND No
Cortisone No ND No
Cyclacillin Yes L No
Cyclophosphamide Yes L ND
Cycloserine Yes L ND
Cyclosporine No ND No
Cysteamine ND ND No
Cytarabine No ND No
Dacarbazine ND ND ND
Daclizumab U ND U
Dactinomycin ND ND ND
Dalteparin U ND U
Danaparoid ND ND ND
Dapsone Yes L ND
Daunorubicin ND ND ND
Deferoxamine Yes L ND
Deflazacort No ND U
Delavirdine U ND U
Desipramine No ND No
Desmopressin ND ND ND
Dexamethasone No ND No
Dexfenfluramine ND ND ND
Dexrazoxane ND ND ND
Dezocine ND ND ND
Diazepam No ND U
Diazoxide Yes L Yes
Dibekacin Yes L ND
Diclofenac U ND U
Dicloxacillin No ND No
Didanosine No ND No
Diethylpropion ND ND ND
Diflunisal No ND U
Digitoxin No ND No
Digoxin No ND No
Dihydroergotamine ND ND ND
Diltiazem No ND No
Diphenhydramine U ND U
Diphenoxylate/Atropine ND ND ND
Dipyridamole U ND ND
Dirithromycin No ND No
Disopyramide Yes L ND
Dobutamine No ND No
Docetaxel U ND U
Dolasetron ND ND ND
Donepezil U ND U
Dopamine No ND U
Doxacurium No ND U
Doxazosin No ND No
Doxepin No ND No
Doxercalciferol No ND U
Doxorubicin No ND ND
Doxycycline No ND No
Dronabinol U ND U
Droperidol U ND U
Edetate calcium (EDTA) Yes L Yes
Efavirenz U ND U
Enalapril (enalaprilat) Yes L Yes
Encainide No ND ND
Enoxacin No ND No
Enoxaparin No ND U
Ephedrine ND ND ND
Epinephrine ND ND ND
Epoetin alfa No ND No
Epoprostenol ND ND ND
Eprosartan U No U
Eptifibatide ND ND ND
Ergocalciferol ND ND ND
Erythromycin No ND No
Esmolol (ASL-8123) Yes L Yes
Estazolam U ND U
Ethacrynic acid No ND U
Ethambutol No No U
Ethchlorvynol No ND No
Ethinyl estradiol ND ND No
Ethosuximide Yes L ND
Etodolac No ND U
Etoposide No ND No
Famciclovir (penciclovir) Yes L ND
Famotidine No ND No
Felbamate ND ND ND
Felodipine No ND U
Fenfluramine ND ND ND
Fenofibrate No ND U
Fenoldopam U ND No
Fenoprofen No ND U
Fentanyl ND ND ND
Ferric gluconate No ND U
Ferrous (iron) salts U ND U
Fexofenadine No ND U
Filgrastim No ND U
Finasteride U ND U
Flecainide No ND U
Fleroxacin No No No
Floxuridine ND ND ND
Fluconazole Yes L Yesa
Flucytosine Yes L Yes
Fludarabine ND ND ND
Flumazenil ND ND ND
Fluorouracil Yes L ND
Fluoxetine No ND No
Fluphenazine U ND U
Flurazepam No ND U
Flurbiprofen ND ND No
Flutamide No ND U
Fluvastatin U ND U
Fluvoxamine U ND U
Fomepizole Yes L ND
Foscarnet Yes Yes ND
Fosfomycin Yes L ND
Fosinopril (fosinoprilat) No ND No
Fosphenytoin U ND U
Furosemide No ND U
Fusidic acid No ND No
Gabapentin Yes L ND
Gadodiamide Yes L No
Gadoversetamide ND Yes ND
Gallium ND ND ND
Gallopamil U ND U
Ganciclovir Yes L ND
Ganirelix ND ND ND
Gemcitabine ND ND ND
Gemfibrozil No ND No
Gentamicin Yes Yes Yes
Glatiramer ND ND ND
Glimepiride U ND U
Glipizide U ND U
Glucagon U ND U
Glutethimide No ND No
Glyburide No ND U
Gold sodium thiomalate No ND U
Granisetron ND ND ND
Grepafloxacin ND ND ND
Guanabenz U ND ND
Guanadrel ND ND ND
Guanethidine ND ND ND
Guanfacine No ND No
Halofantrine ND ND ND
Haloperidol No ND No
Heparin No ND No
Hexobarbital No ND U
Hirudin No No ND
Hydralazine No ND No
Hydrochlorothiazide No ND U
Hydrocodone ND ND ND
Hydrocortisone U ND U
Hydromorphone ND ND ND
Hydroxychloroquine ND ND ND
Hydroxyurea No ND U
Hydroxyzine No ND No
Ibuprofen No ND U
Ibutilide ND ND ND
Idarubicin U ND U
Ifosfamide Yes L ND
Imipenem Yes L Yes
Imipramine No ND No
Immune globulin(human) U ND U
Indapamide No ND U
Indinavir ND ND ND
Indomethacin No ND U
Insulin No ND No
Interferons No ND No
Iodixanol Yes L ND
Iopromide Yes Yes ND
Irbesartan No ND ND
Irinotecan (SN-38 metabolite) U ND U
Iron dextran No ND U
Isocarboxazid ND ND ND
Isoniazid No No U
Isoproterenol ND ND ND
Isosorbide dinitrate No ND No
Isosorbide mononitrate Yes L No
Isradipine No ND No
Itraconazole No ND U
Kanamycin Yes L Yes
Ketoconazole No ND No
Ketoprofen U ND U
Ketorolac U ND U
Labetalol No ND No
Lamivudine No ND U
Lamotrigine No ND U
Lansoprazole No ND U
Leflunomide No ND No
Letrozole ND ND ND
Leuprolide ND ND ND
Levamisole ND ND ND
Levobupivacaine U ND U
Levofloxacin U ND U
Levonorgestrel U ND U
Levorphanol ND ND ND
Levothyroxine U ND U
Lidocaine No ND U
Lincomycin No ND No
Lisinopril Yes L ND
Lithium Yes L Yes
Lomefloxacin No ND No
Lomustine No ND U
Loperamide ND ND ND
Loracarbef Yes L ND
Loratadine No ND No
Lorazepam No ND U
Losartan No ND No
Lovastatin U ND U
Loxapine ND ND ND
Mangafodipir ND ND ND
Mannitol Yes L Yes
Maprotiline No ND U
Mechlorethamine No ND No
Meclofenamate U ND U
Mefenamic acid No ND U
Mefloquine U ND U
Melphalan No ND ND
Meperidine No ND U
Meprobamate Yes L Yes
Mercaptopurine Yes L ND
Meropenem Yes L ND
Mesalamine (5-ASA) U ND U
Mesna ND ND ND
Mesoridazine U ND U
Metaproterenol ND ND ND
Metformin Yes L ND
Methadone No ND No
Methaqualone No ND No
Methenamine ND ND ND
Methicillin No ND No
Methimazole No ND No
Methotrexate Yes Yes No
Methyldopa Yes L Yes
Methylphenidate U ND U
Methylprednisolone Yes L ND
Metoclopramide No ND No
Metolazone No ND U
Metoprolol Yes L ND
Metronidazole Yes L No
Mexiletine Yes L No
Mezlocillin Yes L No
Miacalcin ND ND ND
Miconazole No ND No
Midazolam No ND U
Midodrine (de-glymidodrine) Yes ND NA
Miglitol ND ND ND
Milrinone ND ND ND
Minocycline No ND No
Minoxidil Yes L Yes
Mirtazapine U ND U
Misoprostol U ND U
Mitomycin ND ND ND
Mitoxantrone No ND No
Mivacurium ND ND ND
Modafinil ND ND ND
Moexipril ND ND ND
Molindone U ND U
Montelukast U ND U
Moricizine U ND U
Morphine Yes ND No
Muromonab-CD3 U ND U
Mycophenolate (mycophenolic acid) No ND No
Nabumetone No ND ND
Nadolol Yes L ND
Nafcillin No ND No
Nalmefene No ND U
Naloxone ND ND ND
Naltrexone ND ND ND
Naproxen No ND U
Naratriptan ND ND ND
Nefazodone U ND U
Nelfinavir U ND U
Netilmicin Yes L Yes
Nevirapine ND ND ND
Nicardipine No ND U
Nicotine ND ND ND
Nicotinic acid ND ND ND
Nifedipine No ND No
Nilutamide ND ND ND
Nimodipine No ND No
Nisoldipine No ND No
Nitrendipine No ND U
Nitrofurantoin Yes L ND
Nitroglycerin No ND No
Nitroprusside Yes L Yes
Nizatidine No ND No
Nomifensine ND ND ND
Norethindrone ND ND No
Norfloxacin No ND U
Nortriptyline No ND No
Octreotide Yes L ND
Ofloxacin Yes ND No
Olanzapine No ND No
Olsalazine U ND U
Omapatrilat No ND ND
Omeprazole U ND U
Ondansetron U ND U
Orbofiban Yes L ND
Orlistat U ND U
Ornidazole Yes L No
Orphenadrine ND ND ND
Oxacillin No ND No
Oxaprozin No ND U
Oxazepam No ND U
Oxybutynin ND ND ND
Oxycodone ND ND ND
Oxymorphone ND ND ND
Paclitaxel No ND U
Pamidronate ND ND ND
Pancuronium ND ND ND
Pantoprazole No ND ND
Paricalcitol No ND ND
Paroxetine No ND U
Pefloxacin No ND No
Pegaspargase U ND U
Pemoline Yes L No
Penbutolol No ND No
Penicillamine Yes L ND
Pencillin G Yes L No
Pentamidine No ND No
Pentazocine Yes L ND
Pentobarbital No ND U
Pentosan polysulfate ND ND ND
Pentostatin ND ND ND
Pentoxifylline U ND ND
Pergolide U ND U
Perindopril (perindoprilat) Yes L ND
Perphenazine U ND U
Phenelzine ND ND ND
Phenobarbital Yes L Yes
Phentermine ND ND ND
Phentolamine ND ND ND
Phenylbutazone No ND U
Phenylpropanolamine ND ND ND
Phenytoin No Yes No
Pimagedine (aminoguanidine) Yes ND ND
Pimozide ND ND ND
Pindolol ND ND ND
Pioglitazone U ND U
Piperacillin Yes L No
Piroxicam U ND U
Plicamycin ND ND ND
Polythiazide No ND No
Pralidoxime ND ND ND
Pramipexole No ND U
Pravastatin No ND ND
Prazepam No ND U
Prazosin No ND No
Prednisone No ND No
Primidone Yes L ND
Probucol No ND No
Procainamide Yes L No
Procarbazine ND ND ND
Prochlorperazine U ND U
Promazine U ND U
Promethazine No ND ND
Propafenone No ND No
Propofol U ND U
Propoxyphene No ND No
Propranolol No ND No
Protriptyline No ND No
Pseudoephedrine No ND U
Pyrazinamide Yes Yes No
Pyrimethamine ND ND ND
Quazepam U ND U
Quetiapine ND ND ND
Quinapril (quinaprilat) No ND No
Quinidine No ND No
Quinine No ND No
Quinupristin/dalfopristin ND ND No
Rabeprazole U ND U
Raloxifene U ND U
Ramipril (ramiprilat) No ND ND
Ranitidine No ND No
Recainam No ND U
Repaglinide U ND U
Reserpine No ND No
Reteplase ND ND ND
Reviparin No ND U
Rifabutin U ND U
Rifampin No No No
Rifapentine U ND U
Rilmenidine No ND U
Rimantadine No ND U
Risperidone ND ND ND
Ritodrine Yes L Yes
Ritonavir U ND U
Rizatriptan ND ND ND
Rocuronium ND ND ND
Rofecoxib No ND U
Ropinirole U ND U
Rosiglitazone No ND U
Roxithromycin ND ND No
Rufloxacin ND ND ND
Salsalate Yes L No
Saquinavir U ND U
Sargramostim ND ND ND
Secobarbital No ND No
Selegiline ND ND ND
Sermorelin ND ND ND
Sertindole No ND ND
Sertraline No ND U
Sevelamer U U U
Sibutramine U ND U
Sildenafil U ND U
Silver No ND U
Simvastatin U ND U
Sirolimus U ND ND
Sisomicin Yes L ND
Somatropin U ND U
Sotalol Yes L ND
Sparfloxacin ND ND ND
Spectinomycin Yes L Yes
Spirapril (spiraprilat) U ND U
Spironolactone U ND U
Stavudine ND ND ND
Streptomycin Yes L Yes
Streptozocin ND ND ND
Sucralfate No ND No
Sufentanil U ND U
Sulbactam Yes L No
Sulfamethoxazole Yes L No
Sulfisoxazole Yes L Yes
Sulindac No ND U
Sumatriptan ND ND ND
Tacrine ND ND ND
Tacrolimus No ND U
Tamoxifen ND ND ND
Tamsulosin U ND U
Tazobactam Yes L No
Teicoplanin No ND No
Telmisartan U ND U
Temazepam No ND U
Temocillin Yes L No
Teniposide U ND U
Terazosin No ND No
Terbinafine U ND U
Terbutaline ND ND ND
Testosterone U ND U
Tetracycline No ND No
Thalidomide ND ND ND
Theophylline Yes L No
Thiethylperazine ND ND ND
Thioguanine ND ND ND
Thioridazine U ND U
Thiotepa ND ND ND
Thiothixene U ND U
Tiagabine No ND ND
Ticarcillin Yes L No
Ticlopidine U ND U
Tiludronate U ND U
Timolol No ND No
Tinidazole Yes L ND
Tirofiban Yes L ND
Tizanidine ND ND ND
Tobramycin Yes L Yes
Tocainide Yes L ND
Tolazamide U ND U
Tolbutamide No ND U
Tolcapone U ND ND
Tolmetin U ND U
Tolterodine U ND U
Topiramate Yes L ND
Topotecan ND ND ND
Torsemide No ND U
Tramadol No ND U
Trandolapril (trandolaprilat) Yes L ND
Tranexamic acid ND ND ND
Tranylcypromine ND ND ND
Trapidil ND ND ND
Trazodone U ND U
Tretinoin ND ND ND
Triamterene ND ND ND
Triazolam No ND U
Trifluoperazine No ND No
Triflupromazine U ND U
Trihexyphenidyl ND ND ND
Trimethoprim Yes L No
Trimetrexate U ND U
Trimipramine U ND U
Troglitazone U ND U
Tropisetron U ND U
Trovafloxacin No ND ND
Ursodiol U ND U
Valacyclovir Yes L ND
Valproic acid No ND No
Valsartan U ND U
Vancomycin No Yes No
Vecuronium U ND U
Venlafaxine No ND U
Verapamil No ND No
Vigabatrin Yes L ND
Vinblastine ND ND ND
Vincristine ND ND ND
Warfarin No ND No
Zafirlukast U ND U
Zalcitabine ND ND ND
Zidovudine/GZDV No/Yes ND/L No/Yes
Zileuton No ND U
Zolmitriptan ND ND ND
Zolpidem No ND U

Yes- dialyzable, No-not dialyzable, U-unlikely, L-likely but no data, ND-no data, NS- no high permeability membrane specified

See Also

References

  1. Dialysis of Drugs. Nephrology Pharmacy Associates. 2000.

Authors:

Ross Donaldson