Drug	Normal dosage	CrCl (mL/min/1.73 m2 )		Adjusted dosage
Acyclovir	200 mg orally three times daily	< 10		200 mg every 12 hours
	400 mg orally every 12 hours	< 10		200 mg every 12 hours
	800 mg orally every 4 hours	10 to 25		800 mg every 8 hours
	800 mg orally every 4 hours	< 10		800 mg every 12 hours
Cidofovir	5 mg per kg IV every other week (with probenecid)	Increase in serum creatinine of 0.3 to 0.4 above baseline		3 mg per kg
		Increase in serum creatinine of 0.5 above baseline or 3+ proteinuria		Discontinue
Ciprofloxacin	500 mg orally every 12 hours	30 to 50		250 to 500 mg every 12 hours
		< 30		250 to 500 mg every 18 hours
Clarithromycin	500 mg twice daily	< 30		1/2 dose (or double interval)
Famciclovir	500 mg orally every 12 hours	20 to 39		250 mg every 12 hours
		< 20		250 mg every 24 hours
Fluconazole	50 to 400 mg orally every day	10 to 50		1/2 dose
		< 10		1/4 dose
		Dialysis		Full dose after dialysis
Foscarnet	90 to 120 mg per kg IV every day	CrCl*:		Low dose:		High dose:
			> 1.4		90 mg every 24 hours		120 mg every 24 hours
			1.0 to 1.4		70 mg every 24 hours		90 mg every 24 hours
			0.8 to 1.0		50 mg every 24 hours		65 mg every 24 hours
			0.6 to 0.8		80 mg every 48 hours		105 mg every 48 hours
			0.5 to 0.6		60 mg every 48 hours		80 mg every 48 hours
			0.4 to 0.5		50 mg every 48 hours		65 mg every 48 hours
			< 0.4		Not recommended		Not recommended
Ganciclovir	Oral: 1 g orally three times daily	50 to 69		1,500 mg every day or 500 mg three times daily
		25 to 49		1,000 mg every day or 500 mg twice daily
		10 to 24		500 mg every day
		< 10		500 mg three times weekly after dialysis
	IV: 5 mg per kg every day or 6 mg per kg every day × 5 days per week	50 to 69		2.5 mg per kg every 24 hours
		25 to 49		1.25 mg per kg every 24 hours
		10 to 24		0.625 mg per kg every 48 hours
		< 10		0.625 mg per kg three times weekly
TMP-SMZ	1 DS every day	< 30		1/2 dose
	1 DS three times weekly
	1 SS every day