Drug use and dosing hepatic failure
Hepatic impairment predisposes patients to failure in drug treatment due to both pharmacokinetic and pharmacodynamic alterations occurring in liver diseases (1,2). When treating patients with hepatic impairment, selecting the appropriate drug and the appropriate dose deserves careful consideration. On many occasions, these requirements are not necessarily met. Up to 30% of patients with liver cirrhosis experience adverse drug reactions; 80% of these could potentially be prevented (3).
30%
“Up to 30% of patients with liver cirrhosis experience adverse drug reactions.”
Clinical solution
Heparbase helps advance the safe and appropriate use of drugs in patients with impaired hepatic function. The user is provided with detailed dosing recommendations in each category of hepatic impairment, information on potential hepatotoxicity of drugs and pharmacological backgrounds of the recommendations.
Key characteristics
of Heparbase:
- Analysis of the pharmacokinetics and safety of drugs during hepatic impairment
- Dosing recommendations for three categories of hepatic impairment, based on classification recommended by the European Medicines Agency (EMA)
- Indication of potential hepatotoxicity and evaluation of need for laboratory or clinical monitoring
- Enables assessment of drug use and dosing throughout different stages of hepatic impairment
Classification methodology
The degree of hepatic impairment, based on the Child-Pugh classification, is divided into three categories, as recommended by the European Medicines Agency (EMA):
| Child-Pugh A (score 5–6) | Mild hepatic impairment | |
| Child-Pugh B (score 7–9) | Moderate hepatic impairment | |
| Child-Pugh C (score 10–15) | Severe hepatic impairment |
Classification of dosing recommendations
Each recommendation is graded in Heparbase. The recommendations are coded with a traffic light-like system and letters (A–D), according to the need for clinical action.
| D | The use should be avoided |
| C | Modification of the dose or dosage interval is needed |
| B | The information is not available, or the recommendation is estimated based on the pharmacologic characteristics of the substance |
| A | No need for dosing modification |
Languages and local drug registries
Medbase content is available in English and more than ten additional languages. To further improve local usability, we accommodate national, local and customer-specific drug product registries, allowing access to information using local drug product names and IDs.
Integration with local electronic health record (EHR) systems is straightforward, enabling smooth and efficient use of regularly updated Medbase drug information across various countries.
Latest information from trusted sources
All information is based on scientific evidence. We refer to published, peer-reviewed research articles from PubMed, a reliable source of biomedical and life sciences literature, as well as regulatory authority approved documents, such as the Summaries of Product Characteristics (SPC) of drugs.
Medbase Knowledgebase is continuously updated to ensure the inclusion of the latest information.
Supporting informed decisions for safe drug use
Enhanced patient safety
Holistic approach to patient’s pharmacotherapy enabling individualised drug treatment.
100% Evidence-based
Fully referenced information with transparency to original sources: documents approved by regulatory authorities and peer-reviewed literature.
Clinical relevance
We provide comprehensive and concise information for safe use of drugs, accessible from one single source.
Digitalised doctor consultation
Designed to support busy clinical practice for safe use of drugs. All information is created and validated by physicians specialised in clinical pharmacology.
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- Verbeek. Pharmacokinetics and dosage adjustment in patients with hepatic dysfunction. Eur J Clin Pharmacol. (2008). 64(12): 1147-1161.
- Weersink et al. Evidence-Based Recommendations to Improve the Safe Use of Drugs in Patients with Liver Cirrhosis. Drug Saf. (2018). 41(6): 603-613.
- Dose adjustment in patients with liver cirrhosis: impact on adverse drug reactions and hospitalizations. Eur J Clin Pharmacol. (2013). 69(8): 1565–1573.