Essential Drug Dosing Guide

A quick guide for PHC prescribers (CHEW & Midwives) and Pharmacy Technicians

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1. Artesunate
Dosing
Requirement Effects of Common Drug Pregnancy
Drug Interactions
(mg/kg body Interactions Advice Alert
weight)
Lopinavir/ritonavir
increase the level
of artesunate in
the body
Adult and 1.Lopinavir/ritonavir increasing side
children 2. Efavirenz effect.
weighing >20k, 3. Nevirapine Efavirenz and
dose at Nevirapine
2.4 mg/kg at decreases the
0hr, 12hr, level of Take with food.
24hrs. artesunate and its For injection,
Children efficacy continue for
weighing <20k minimum of
dose at 24hr and It is safe in
3mg/kg. switch to oral pregnancy
Then once ACT as soon as and during
daily for the patient can breastfeeding
maximum of 6 tolerate it.
days. Use for Carbamazepine, Please ensure
minimum of Phenobarbital and that you don't
24hrs then Carbamazepine, Phenytoin can lead mix with water
switch to oral Phenobarbital and to decreased level
ACT for 3days Phenytoin of artesunate
once patient thereby reducing its
can tolerate efficacy
oral.
 2. Artemether
Dosing
Requirement Common Drug
Drug Interactions Effects of Interactions Pregnancy Alert
(mg/kg body Advice
weight)
Lopinavir/ritonavir
increase the level of Take with
artesunate in the body food.
1.Lopinavir/ritonavir increasing side effect. For injection,
3.2 mg/kg on 2.Efavirnez Efavirenz and Nevirapine continue for
Day 1, then 3.Nevirapine decreases the level of minimum of It is safe in
1.6 mg/kg artesunate and its 24hr and pregnancy and
daily till efficacy switch to oral during
patient can
ACT as soon breastfeeding
tolerate oral Carbamazepine, as the patient
Phenobarbital and
Carbamazepine, can tolerate
Phenytoin can lead to
Phenobarbital and it.
decreased level of
Phenytoin artesunate thereby
reducing its efficacy.

3. Amoxicillin
Dosing Requirement Common Drug Pregnancy
Drug Interactions Effects of Interactions
(mg/kg body weight) Advice Alert
By mouth:
Children up to 10yrs
125mg every 8hrs Oral Reduced efficacy of
(doubled in severe Contraceptives oral contraceptives
infection).
Children above 10yrs Take with or
250mg every 8hrs without food.
It is safe in
(doubled in severe Ciprofloxacin, Complete the
pregnancy
infection). antibiotics like chloramphenicol and full course of
A child having ciprofloxacin, erythromycin can treatment.
confirmed Otitis antagonize the effect
erythromycin,
media dose at of amoxicillin.
chloramphenicol
Tetracyclines can
40mg/kg in 3 divided and reduce the
doses (maximum 3g tetracyclines bactericidal capacity
daily) of amoxicillin
 4. Cefixime
Dosing
Requirement Common Drug Pregnancy
Drug Interactions Effects of Interactions
(mg/kg body Advice Alert
weight)

Take with or
8 mg/kg/day or without food.
4mg/kg every Anticoagulants Increased bleeding Don't mix with
(warfarin) risk It is safe in
12hours Aminoglycoside
pregnancy
(most preferred in same bottle.
and during
ONCE DAILY Complete the
breastfeeding
DOSING) full course of
treatment.
Aminoglycosides increase the risk of
(Gentamycin and nephrotoxicity and ear
streptomycin) damage (ototoxicity)

5. Ceftriaxone
Dosing
Requirement Common Drug Pregnancy
Drug Interactions Effects of Interactions
(mg/kg body Advice Alert
weight)

Calcium Risk of precipitate

Administer via IM
Adult: 1g containing formation in the
or IV.
12hourly (2g is solutions lungs and kidneys
Do not mix with It is safe in
exceptional
calcium pregnancy
cases)
containing and during
Increased bleeding solutions. breastfeeding
General:
risk with Don't mix with
50-75 mg/kg/day
Anticoagulants anticoagulant, Aminoglycoside
Aminoglycosides increase the risk of in same bottle.
nephrotoxicity with
aminoglycoside.
 6. Ciprofloxacin
Dosing
Requirement Common Drug
Drug Interactions Effects of Interactions Pregnancy Alert
(mg/kg body Advice
weight)

Adult 500mg Take with water.

Increased Not safe for
12hrly, Theophylline Avoid dairy
theophylline levels products and use in
pregnancy so
child 1month or antacids e.g.
reserve for
over, dose milk.
Can lead to use only
between 10- Do not mix
precipitation in when there is
15mg/kg twice ciprofloxacin
blood when totally no
daily (!!USE IN infusion with
Ceftriaxone administered in the other safer
CHILDREN ceftriaxone in
same IV line, alternative.
UNDER 12YEAR same line.
especially in
Only where is Use ciprofloxacin
children. Safe for use
no any other with care in
Antacids Reduced absorption children below 12 during
safer antibiotic
and of ciprofloxacin when years. breastfeeding.
available)
Iron supplement taken with antacid

7. Erythromycin
Dosing Requirement Drug Common Drug Pregnancy
Effects of Interactions
(mg/kg body weight) Interactions Advice Alert

30-50 mg/kg/day in Increased risk of

simvastatin
divided doses myopathy
every 6hours.
Take on an empty It is safe in
stomach. pregnancy
Tablet: Child and
adult over 8yrs.,
250 - 500mg every
6hours. increased bleeding
Warfarin
risk
 8. Metronidazole
Dosing
Requirement Common Drug
Drug Interactions Effects of Interactions Pregnancy Alert
(mg/kg body Advice
weight)
Adult 30
mg/kg/day in
divided doses Disulfiram-like Avoid alcohol Safe for use in
every 8hrs. Alcohol reaction with during and for at pregnancy.
Oral: 400 - alcohol least 48 hours use with care
500mg every after treatment. in
8hrly Take tablet after breastfeeding
food to minimize mothers as it
Child: 7.5 - GI effect. is
15mg/kg 8hrly. Suspension is significantly
Child 0 - 1yr, Increased bleeding best taken 1hour present in
Warfarin
risk before food. breast milk.
125mg 8hrly.
1 - 5yrs 250mg
8hrly.

9. Gentamicin
Dosing
Requirement Common Drug Pregnancy
Drug Interactions Effects of Interactions
(mg/kg body Advice Alert
weight)

frusemide,
Increased risk of
NSAIDs,
nephrotoxicity Can cause
Vancomycin
foetal
Administer via IM
2 - 5mg/kg/day ototoxicity,
or IV. Monitor
in divided doses Gentamycin may use only
kidney function
8hrly antagonize the when
Amoxicillin and hearing
effect of amoxicillin abilities. BENEFIT
in some situations OUTWEIGH
RISK.
Neuromuscular
Blocking Agents
ototoxicity
(e.g.
succinylcholine)
 10. Paracetamol
Dosing
Requirement Common Drug
Drug Interactions Effects of Interactions Pregnancy Alert
(mg/kg body Advice
weight)

Do not exceed
Increased risk of the
10 mg/kg every Alcohol It is safe in
liver damage recommended 4g
8 hours (max pregnancy
per day.
4g/day) and during
Can cause severe
5mg/kg if breastfeeding
liver damage
jaundiced.
when used with
Increased bleeding alcohol.
Warfarin
risk

11. Diclofenac
Dosing
Requirement Common Drug Pregnancy
Drug Interactions Effects of Interactions
(mg/kg body Advice Alert
weight)

Increased risk of
Ciprofloxacin
seizure Take it with food
CHILD >1YR, or milk to reduce
0.5 - 2 GI irritation.
mg/kg/day Increased risk of GI Monitor for
Other NSAID disturbance and gastrointestinal CONTRA-
ADULT: 75mg IM (ibuprofen etc) cardiovascular side issues. INDICATED
once or twice effect Avoid alcohol to
daily (in severe reduce risk of GI
cases) and not bleeding.
more than Not advisable to
2days. administer to
Reduced efficacy of
Diuretics children <1yr
diuretics
 12. Ibuprofen
Dosing
Requirement Common Drug Pregnancy
Drug Interactions Effects of Interactions
(mg/kg body Advice Alert
weight)

Increased bleeding
Anticoagulants
risk
Child >3moths:
5-10 mg/kg Take it with food
every 6-8 hrly. or milk. Monitor
CONTRA-
Child 12yrs and for
INDICATED
above and gastrointestinal
adult: 200mg - issues.
400mg 6 - 8hrly
with food. Diuretics reduced efficacy of
(Frusemide) diuretics