There are two places within DoseMeRx where eCrCl is calculated and used - 1) within the drug model that determines medication dosing and 2) for display on the Dosing Report page.
On the Dosing Report page, the method for calculating the eCrCl is indicated in parenthesis after the displayed value. Unless otherwise noted, for adults, eCrCl is calculated using Cockcroft-Gault, using the lower of ideal body weight (IBW) or total body weight (TBW) , and a minimum serum creatinine of 0.68 mg/dL (60 µmol/L) as described by Duffull et al. (Br J Clin Pharmacol 1997; 43: 125–135) . We do this to avoid estimating unphysiologically high CrCL which could otherwise occur for outlier patients with low serum creatinine results. For pediatrics, we utilize Schwartz unless otherwise noted.
If enabled, the eCrCL will be displayed in the pharmacokinetics section of the final dosing recommendation report, allowing for a convenient comparison. Both the calculation using IBW and TBW will be displayed.
When used as part of the drug model calculations, the methodology described above is followed. However, for some models, such as the Adane obese vancomycin model, tobramycin, and methotrexate, the methodology described in the original paper is used. Additional information for these exceptions can be found in the Drug Information section when you are logged into your DoseMeRx account.
If you have any questions about DoseMeRx and how the platform calculates estimated creatinine clearance, please contact DoseMeRx Support.