BMJ  2005;331:292 (30 July), doi:10.1136/bmj.331.7511.292

Letter

Dose adjustment in renal impairment

Response from the British National Formulary

The first 150 words of the full text of this article appear below.

EDITOR—Vidal et al are rightly concerned that information on dose adjustment is not as well supported by evidence as our knowledge about the effectiveness of modern interventions (p 263). ¹ But, as they have found, the lack of robust data to guide clinicians on the precautions to take when using drugs is woeful. Therefore, their conclusions come as no surprise to compilers of drug information.

Because there are few accessible studies on dose adjustment in renal impairment, the British National Formulary (BNF) has to rely on summaries of product characteristics, which reflect data submitted for gaining marketing authorisation. However, the BNF continually adjusts its position as clinically relevant information emerges; this process is summarised in appendix 2 of Vidal et al's paper.

Vidal et al's comparison of information on drugs in renal impairment was prompted by the need to populate a computerised decision support system. . . . [Full text of this article]

British National Formulary, Royal Pharmaceutical Society of Great Britain, London SE1 7JN dmehta@bnf.org

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