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Of the dose investigation studies included, one cited Bayesian methods for study analysis and one to guide mid-trial dosing adaptations.
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The recommendations include adjustment to blood trough levels for the two drugs or dosing adaptation based on elevated serum creatinine levels.
No dose adaptations will be made for study purposes.
Dose adaptations were performed as described elsewhere [ 15].
Diarrhoea peaked in cycle 2, and was reduced in the following cycles by dose adaptations.
There was a mean of 2.3 filtration dose prescriptions per patient over the observation period (due to changing clinical conditions), with a total of 77 dose adaptations.
MMF dose adaptations were initially made on the basis of tolerance and clinical response, and the inclusion MMF dose was maintained throughout follow-up.
Intradialytic heparin anticoagulation was carried out according to standard procedures and continued without dose adaptations in both arms of the study; priming of the dialyser was heparin free.
Only a few (approximately 10%) patients required dose adaptations during cross-over, primarily when treatment was switched from methadone to SROM.
Effectively, dose adaptations are proposed by the different regulatory agencies for dabigatran etexilate, rivaroxaban, and apixaban regarding the degree of renal insufficiency [ 3– 8].
This is not unexpected as malignant pain treatment is relatively short term and frequent dose adaptations are necessary owing to the increase in pain.
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