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Using this page · Individualise medicines monitoring mindful of current blood tube shortage

This medicines monitoring page has been written using publications and expert opinion. It is designed to save clinician time, but not replace professional responsibility. When using this page you should: ensure an individualised monitoring plan is developed in partnership with the patient; take account of any locally agreed advice and guidance; be aware of recently published advice on specimen collection supply disruption.

Before starting

Required

  • Baseline
    • Full blood count
    • Liver function tests
    • Serum creatinine (for creatinine clearance) or Estimated glomerular filtration rate
    • Urea and electrolyes
    • Urine dipstick

Continued until stable

Required

  • 14 days after starting; then at 4, 8, and 12 weeks; then 3 monthly
    • Full blood count
    • Liver function tests
    • Serum creatinine (for creatinine clearance) or Estimated glomerular filtration rate
    • Urea and electrolyes
    • Urine dipstick

Ongoing once stable

Required

  • Every 6 months or annually (dependent on risk factors)
    • Full blood count
    • Liver function tests
    • Urea and electrolyes
    • Urine dipstick
  • Every 6 months for first 4 years; then annually
    • Serum creatinine (for creatinine clearance) or Estimated glomerular filtration rate

Abnormal results

Renal function

Stop if deteriorates.

Liver function

If AST or ALT are greater than twice the upper limit of the reference range, stop and discuss with specialist.

Notes

Haematological investigations

Perform haematological investigations if patient develops unexplained bleeding, bruising, purpura, anaemia, fever or sore throat.
Stop if suspicion or evidence of blood dyscrasia.

Bibliography

Enquiries about this page

Contact us if you have any enquiries about the drug monitoring information on this page.