From the Research
Pheniramine injection can be used in patients with chronic kidney disease (CKD), but caution is advised due to the potential for increased side effects and the need for careful monitoring. No specific dose adjustment is typically required for pheniramine in CKD patients, though monitoring for side effects is important, as noted in general principles of drug stewardship in CKD patients 1. Pheniramine is an antihistamine primarily metabolized by the liver, with only partial renal elimination, making it relatively safer compared to medications that rely heavily on kidney excretion.
When administering pheniramine injection to CKD patients, start with the standard dose (usually 20-50 mg intramuscularly or intravenously) and observe for increased sedation, anticholinergic effects (dry mouth, urinary retention, constipation), or hypotension. These side effects may be more pronounced in CKD patients due to potential drug accumulation. The risk of adverse drug reactions, including those that can be serious, is a concern in CKD patients, as highlighted by studies on the burden of such reactions in this population 2.
In severe CKD (stages 4-5) or dialysis patients, consider using a lower dose initially and titrating based on response. Always monitor kidney function regularly when using any medication in CKD patients, and consider consulting with a nephrologist for complex cases. The importance of careful medication management in CKD patients is underscored by the need to balance the risks and benefits of medications, given the potential for altered pharmacokinetics and pharmacodynamics in kidney disease 3.
While specific guidance on pheniramine use in CKD is limited, the principles of drug use in this population emphasize the need for vigilance and adjustment of therapy based on individual patient factors, including the severity of kidney disease and the presence of other comorbid conditions 4, 5.