fe is the abbreviation for fraction of drug excreted unchanged in the urine.
For predominantly renally cleared drugs (fe > 0.5), dose adjustment should be considered in relation to impairment of renal function (creatinine clearance/eGFR).
For medicines that are renally cleared i.e. fe > 0.5.
If further information is required, contact the ward pharmacist or Medicines Information ( 80900).
Note: Maintenance doses should be adjusted to achieve similar concentrations to that which would occur with standard doses in the setting of normal renal function. Adjustment of maintenance doses includes changes to dose, frequency or both (e.g. smaller dose, reduced frequency). The following is not an exhaustive list. These have been selected from a list of commonly prescribed medicines on the basis of having a high fe (fraction excreted unchanged in urine), or a moderate fe and low therapeutic index. Nephrotoxicity is not a factor for inclusion in this list.
Drug (active metabolite) |
fe, fraction excreted unchanged in urine |
Location of more detailed guidance |
aciclovir |
0.8 |
|
allopurinol (oxypurinol) |
0 (0.8) |
|
amoxicillin |
0.9 |
|
atenolol |
0.9 |
|
baclofen |
0.8 |
|
benzylpenicillin |
0.8 |
|
bezafibrate |
0.4 |
|
bisoprolol |
0.5 |
|
candesartan |
0.6 |
|
captopril |
0.5 |
|
cefaclor |
0.7 |
|
cefalexin |
0.9 |
|
cefazolin |
0.9 |
|
cefepime |
0.8 |
|
cefotaxime |
0.7 |
|
ceftazidime |
0.9 |
|
ceftriaxone |
0.5 |
|
cefuroxime |
0.9 |
|
cetirizine |
0.7 |
|
cilazapril (cilazaprilat) |
0 (0.9) |
|
ciprofloxacin |
0.5 |
|
clonidine |
0.6 |
|
colchicine |
0.3 |
|
dabigatran |
0.8 |
|
digoxin |
0.8 |
|
doxycycline |
0.4 |
|
enalapril (enalaprilat) |
0.2 (0.8) |
|
enoxaparin |
0.7 |
|
ethambutol |
0.8 |
|
flecainide |
0.3 |
|
flucloxacillin |
0.7 |
|
fluconazole |
0.8 |
|
gabapentin |
0.9 |
|
ganciclovir |
0.9 |
|
gemfibrozil |
0.6 |
|
gentamicin |
0.9 |
|
imipenem |
0.7 |
|
lamivudine |
0.8 |
|
levetiracetam |
0.7 |
|
lisinopril |
0.9 |
|
lithium |
1 |
|
meropenem |
0.7 |
|
metformin |
0.9 |
|
methotrexate |
0.9-0.5 (saturable) |
|
morphine (m-6-glucuronide) |
0 (0.9) |
|
nadolol |
0.8 |
|
nicotinic acid |
0.4 |
|
pethidine (norpethidine) |
0 (0.9) |
|
phenoxymethylpenicillin |
0.9 |
|
piperacillin |
0.8 |
|
pravastatin |
0.5 |
|
quinapril (quinaprilat) |
0 (0.9) |
|
rivaroxaban |
0.4 |
|
sotalol |
0.9 |
|
teicoplanin |
0.8 |
|
tobramycin |
0.9 |
|
tramadol (O-desmethyltramadol (M1)) |
0.2 (0.9) |
|
tranexamic acid |
0.9 |
|
valganciclovir |
0.8 |
|
vancomycin |
0.9 |
|
varenicline |
0.9 |
|
Topic Code: 191845