Dose adjustment recommendations were also provided based on continuous safety assessments.
Since specific dose adjustment recommendations are not available, concomitant administration of potent CYP3A-modulating comedication should generally be avoided.
Specifically, therapeutic adjustment recommendations, adherence support and monitoring can all occur in-line with regular visits to the pharmacy.
Extending the availability of renal laboratory data to community pharmacists resulted in their presenting the prescribing physicians with a considerable number of medication adjustment recommendations.
The issuance of eGFR alerts allowed community pharmacists to provide valuable medication adjustment recommendations to the prescribing physicians, with a good acceptance rate.
Any medication adjustment recommendations were recorded, which included the patient's medical record number, the pharmacist, the type and daily dose of the medication, and the prescribing physician (GP or clinician).
HD patients were given simvastatin during the conversion due to dose adjustment recommendations for cerivastatin in patients with renal insufficiency and lack of experience with this drug in ESRD.
An overview of the type of medication errors that were identified by the pharmacists is given in figure 4. Figure 5 gives an overview of the frequency and types of medication adjustment recommendations.
In order to promote further concrete application of and research on CYP2D6 pharmacogenetic genotyping in medical practice, dose-adjustment recommendations based on available published pharmacokinetic data have been derived (see [ 22– 22]).
At this time no specific Rosuvastatin dose adjustment recommendations exist for concurrent administration with Lopinavir/Ritonavir or other protease inhibitors, and until additional efficacy and safety information becomes available, caution should be used with this combination in HIV-infected patients on HAART.
