Prokinetic Medications for Patients with End-Stage Renal Disease on Hemodialysis

Medication Administration and Monitoring

Medications should generally be administered after hemodialysis sessions to avoid premature drug removal, and serum drug concentration monitoring may be necessary to ensure adequate dosing without toxicity 1
Administration should occur after hemodialysis to prevent premature drug removal and maintain therapeutic drug levels between dialysis sessions 1
The American Thoracic Society, as published in the American Journal of Respiratory and Critical Care Medicine, recommends that all medications should be given after hemodialysis to facilitate directly observed therapy and avoid premature drug removal 1

Aminoglycoside antibiotics and tetracyclines should be avoided in ESRD patients due to nephrotoxicity, as recommended by the International Journal of Oral Science 2
For any medication, nephrotoxic drugs should be avoided entirely in ESRD patients, according to the International Journal of Oral Science 2
ESRD patients may have additional clinical conditions (like diabetes with gastroparesis) that affect drug absorption, as noted in the American Journal of Respiratory and Critical Care Medicine 1