Etopride Dosing in Chronic Kidney Disease
I cannot provide specific dosing recommendations for etopride in CKD based on eGFR because no evidence in the provided literature addresses etopride dosing adjustments for renal impairment.
Critical Issue: Absence of Etopride-Specific Data
The provided evidence contains:
- No FDA drug label for etopride (only etoposide, a chemotherapy agent, was provided 1)
- No guidelines addressing etopride (a prokinetic agent)
- No research studies on etopride pharmacokinetics in CKD
The evidence mistakenly includes etoposide (an antineoplastic agent) 1, which is an entirely different medication from etopride (levosulpiride/levopride, a prokinetic dopamine antagonist).
General Principles for Renally-Cleared Prokinetic Agents
While I cannot provide etopride-specific recommendations, general principles for renally-cleared drugs suggest 2:
- Drugs cleared renally require dosage adjustment based on creatinine clearance or GFR
- Dose adjustments typically involve dose reduction, lengthening dosing intervals, or both
- Close monitoring is essential for adverse effects such as extrapyramidal symptoms and QT prolongation, which may be exacerbated by drug accumulation in renal impairment 2
Clinical Recommendation
You must consult the manufacturer's prescribing information for etopride-specific renal dosing recommendations 2. The absence of this critical information in standard references means:
- Contact the pharmaceutical manufacturer directly
- Review country-specific drug formularies where etopride is approved
- Consider alternative prokinetic agents with established renal dosing guidelines if etopride information is unavailable
Important Caveat
Do not extrapolate etoposide dosing (creatinine clearance >50 mL/min: 100% dose; 15-50 mL/min: 75% dose) 1 to etopride, as these are pharmacologically distinct medications with different elimination pathways and safety profiles.