Canterbury DHB
Serum albumin and the prothrombin ratio best reflect liver metabolic capacity. An albumin of <30 g/L and an INR of >1.2 indicates significant liver dysfunction, provided there is no other explanation for these abnormal results.
In practice, however, many trials and drug manufacturers make dose reduction recommendations based on bilirubin levels. This will not be valid if the patient has Gilbert’s disease.
For more detailed information, see The Pink Book or page the Haematology pharmacist on 8209. Also consult the product datasheet (available on the Medsafe website). If the patient is entered into a trial, the trial document should also be consulted.
Topic Code: 5728