The ability of dialysis to remove a toxin is based on:

  • Molecular weight (size)
  • Protein binding (the more binding present, the harder it is to remove)
  • Volume of distribution ( the higher the harder it is to remove)
  • Water solubility (the more fat soluble and less water soluble a drug, the harder it is to remove)
  • Plasma clearance (how fast it is metabolized by the body)
  • Type of dialysis membrane utilized
  • Dialysis flow rate. 

Emergent dialysis can be necessary in overdose, with specific clinical findings or laboratory abnormalities. Consultation with your local toxicology center is suggested as indications for dialysis vary based on these findings. However, below is a list of the most common agents that can be dialyzed in the setting of overdose. 

  • Acetaminophen(with extremely high levels >900 mg/dL, acidosis, and AMS)
  • Barbiturates (Phenobarbitol OD with coma)
  • Carabamezepine (with refractory seizures or dysrhythmias)
  • Caffeine
  • Dabigatran2
  • Depakote
  • Ethylene Glycol
  • Isoniazid
  • Lithium
  • Methanol
  • Metformin
  • Salicylate
  • Thallium2
  • Theophyline
  • Valproic Acid2 (with extremely high levels >1300 mg/L)

This document published by Nephrology Pharmacy Associates in 2000 is a helpful reference. It includes a chart (reproduced below) of drugs encountered up to the year 2000 and their dialysis status by type.  In addition, there is an excellent summary of the chemistry of dialysis and its application to toxicology published by EMCrit here.

Dialyzable Drug List1

Drug NameConventional DialysisHigh PermeabilityPeritoneal Dialysis
AmilorideNDNDND
Aminocaproic acidYesNDYes
AminoglutethimideYesLND
Aminosalicylic acidYesLND
AmiodaroneNoNDNo
AmitriptylineNoNDNo
AmlodipineNoNDNo
AmoxapineUNDU
AmoxicillinYesLNo
Amphotericin BNoNDNo
AmpicillinYesLNo
AmprenavirUNDND
AmrinoneUNDNo
AnagrelideNDNDND
AnastrozoleNDNDND
AnistreplaseUNDU
Antithymocyte globulin ATGUNDU
AprotininUNDU
ArbutamineNDNDND
ArdeparinNoNDND
AsparaginaseUNDU
AspirinYesLYes
AtenololYesLNo
AtorvastatinUNDU
AtovaquoneUNDU
AtracuriumUNDU
AtropineNoNDND
AuranofinNoNDND
AzathioprineYesLND
AzithromycinNDNDND
AzlocillinYesLNo
AztreonamYesLNo
BaclofenNDNDND
BasiliximabUNDU
Benazepril (benazeprilat)NoNDND
BenzquinamideUNDNA
BepridilNoNDU
BetamethasoneNDNDND
BetaxololNoNDNo
BethanecholNDNDND
BezafibrateNoNDNo
BiapenemYesLND
BicalutamideUNDU
BisoprololNoNDND
BleomycinNoNDNo
BretyliumYesLND
BromfenacNoNDU
BromocriptineUNDU
BuflomedilNoNoU
BumetanideNoNDU
BupropionNoNDNo
BuspironeNoNDND
BusulfanNDNDND
ButalbitalNDNDND
ButorphanolUNDU
CaffeineNDNDND
CalcitriolNoNoU
CandesartanNoNDND
CapecitabineNDNDND
CapreomycinYesLND
CaptoprilYesLNo
CarbamazepineNoNDNo
CarbenicillinYesLNo
Carbidopa/levodopaNDNDND
CarboplatinYesLND
CarboprostNDNDND
CarisoprodolYesLYes
CarmustineNoNDND
CarnitineYesLND
CarprofenUNDU
CarteololNDNDND
CarumonamYesLND
CarvedilolNoNDND
CefaclorYesLYes
CefadroxilYesLNo
CefamandoleYesLNo
CefazolinYesLNo
CefdinirYesLND
CefepimeYesLYes
CefiximeNoNDNo
CefmenoximeYesLND
CefmetazoleYesLNo
CefodizimeNoNDNo
CefonicidNoNDNo
CefoperazoneNoNDNo
CeforanideYesLNo
CefotaximeYesLNo
CefotetanYesLYes
CefoxitinYesLNo
CefpiromeYesYesNo
CefpodoximeYesLNo
CefprozilYesLND
CefroxadineNDNDND
CefsulodinYesLYes
CeftazidimeYesLYes
CeftibutenYesLND
CeftizoximeYesLNo
CeftriaxoneNoNDNo
CefuroximeYesLNo
CelecoxibUNDU
CephalexinYesLNo
CephalothinYesLNo
CephapirinYesLNo
CephradineYesLYes
CerivastatinUNDU
CetirizineNoNDU
Chloral HydrateYesLND
ChlorambucilNoNDNo
ChloramphenicolYesLNo
ChlordiazepoxideNoNDU
ChloroquineNoNDNo
ChlorpheniramineYesLNo
ChlorpromazineNoNDNo
ChlorpropamideNoNDNo
ChlorprothixeneUNDU
ChlorthalidoneNoNDU
CidofovirNDYesNo
CilastatinYesLND
CilazaprilYesLND
CilostazolUNDU
CimetidineNoNDNo
CinoxacinNoNDU
CiprofloxacinNoNDNo
CisaprideNoNDU
CisatracuriumUNDU
CisplatinNoNDND
CitalopramUNDU
CladribineNDNDND
ClarithromycinNDNDND
Clavulanic acidYesNDYes
ClemastineNDNDND
ClindamycinNoNDNo
ClodronateYesNDNo
ClofazimineNoNDNo
ClofibrateNoNDNo
ClomipramineUNDU
ClonazepamNoNDU
ClonidineNoNDNo
ClopidogrelUNDU
ClorazepateNoNDU
CloxacillinNoNDNo
ClozapineUNDU
CodeineNoNDU
ColchicineNoNDNo
CortisoneNoNDNo
CyclacillinYesLNo
CyclophosphamideYesLND
CycloserineYesLND
CyclosporineNoNDNo
CysteamineNDNDNo
CytarabineNoNDNo
DacarbazineNDNDND
DaclizumabUNDU
DactinomycinNDNDND
DalteparinUNDU
DanaparoidNDNDND
DapsoneYesLND
DaunorubicinNDNDND
DeferoxamineYesLND
DeflazacortNoNDU
DelavirdineUNDU
DesipramineNoNDNo
DesmopressinNDNDND
DexamethasoneNoNDNo
DexfenfluramineNDNDND
DexrazoxaneNDNDND
DezocineNDNDND
DiazepamNoNDU
DiazoxideYesLYes
DibekacinYesLND
DiclofenacUNDU
DicloxacillinNoNDNo
DidanosineNoNDNo
DiethylpropionNDNDND
DiflunisalNoNDU
DigitoxinNoNDNo
DigoxinNoNDNo
DihydroergotamineNDNDND
DiltiazemNoNDNo
DiphenhydramineUNDU
Diphenoxylate/AtropineNDNDND
DipyridamoleUNDND
DirithromycinNoNDNo
DisopyramideYesLND
DobutamineNoNDNo
DocetaxelUNDU
DolasetronNDNDND
DonepezilUNDU
DopamineNoNDU
DoxacuriumNoNDU
DoxazosinNoNDNo
DoxepinNoNDNo
DoxercalciferolNoNDU
DoxorubicinNoNDND
DoxycyclineNoNDNo
DronabinolUNDU
DroperidolUNDU
Edetate calcium (EDTA)YesLYes
EfavirenzUNDU
Enalapril (enalaprilat)YesLYes
EncainideNoNDND
EnoxacinNoNDNo
EnoxaparinNoNDU
EphedrineNDNDND
EpinephrineNDNDND
Epoetin alfaNoNDNo
EpoprostenolNDNDND
EprosartanUNoU
EptifibatideNDNDND
ErgocalciferolNDNDND
ErythromycinNoNDNo
Esmolol (ASL-8123)YesLYes
EstazolamUNDU
Ethacrynic acidNoNDU
EthambutolNoNoU
EthchlorvynolNoNDNo
Ethinyl estradiolNDNDNo
EthosuximideYesLND
EtodolacNoNDU
EtoposideNoNDNo
Famciclovir (penciclovir)YesLND
FamotidineNoNDNo
FelbamateNDNDND
FelodipineNoNDU
FenfluramineNDNDND
FenofibrateNoNDU
FenoldopamUNDNo
FenoprofenNoNDU
FentanylNDNDND
Ferric gluconateNoNDU
Ferrous (iron) saltsUNDU
FexofenadineNoNDU
FilgrastimNoNDU
FinasterideUNDU
FlecainideNoNDU
FleroxacinNoNoNo
FloxuridineNDNDND
FluconazoleYesLYesa
FlucytosineYesLYes
FludarabineNDNDND
FlumazenilNDNDND
FluorouracilYesLND
FluoxetineNoNDNo
FluphenazineUNDU
FlurazepamNoNDU
FlurbiprofenNDNDNo
FlutamideNoNDU
FluvastatinUNDU
FluvoxamineUNDU
FomepizoleYesLND
FoscarnetYesYesND
FosfomycinYesLND
Fosinopril (fosinoprilat)NoNDNo
FosphenytoinUNDU
FurosemideNoNDU
Fusidic acidNoNDNo
GabapentinYesLND
GadodiamideYesLNo
GadoversetamideNDYesND
GalliumNDNDND
GallopamilUNDU
GanciclovirYesLND
GanirelixNDNDND
GemcitabineNDNDND
GemfibrozilNoNDNo
GentamicinYesYesYes
GlatiramerNDNDND
GlimepirideUNDU
GlipizideUNDU
GlucagonUNDU
GlutethimideNoNDNo
GlyburideNoNDU
Gold sodium thiomalateNoNDU
GranisetronNDNDND
GrepafloxacinNDNDND
GuanabenzUNDND
GuanadrelNDNDND
GuanethidineNDNDND
GuanfacineNoNDNo
HalofantrineNDNDND
HaloperidolNoNDNo
HeparinNoNDNo
HexobarbitalNoNDU
HirudinNoNoND
HydralazineNoNDNo
HydrochlorothiazideNoNDU
HydrocodoneNDNDND
HydrocortisoneUNDU
HydromorphoneNDNDND
HydroxychloroquineNDNDND
HydroxyureaNoNDU
HydroxyzineNoNDNo
IbuprofenNoNDU
IbutilideNDNDND
IdarubicinUNDU
IfosfamideYesLND
ImipenemYesLYes
ImipramineNoNDNo
Immune globulin(human)UNDU
IndapamideNoNDU
IndinavirNDNDND
IndomethacinNoNDU
InsulinNoNDNo
InterferonsNoNDNo
IodixanolYesLND
IopromideYesYesND
IrbesartanNoNDND
Irinotecan (SN-38 metabolite)UNDU
Iron dextranNoNDU
IsocarboxazidNDNDND
IsoniazidNoNoU
IsoproterenolNDNDND
Isosorbide dinitrateNoNDNo
Isosorbide mononitrateYesLNo
IsradipineNoNDNo
ItraconazoleNoNDU
KanamycinYesLYes
KetoconazoleNoNDNo
KetoprofenUNDU
KetorolacUNDU
LabetalolNoNDNo
LamivudineNoNDU
LamotrigineNoNDU
LansoprazoleNoNDU
LeflunomideNoNDNo
LetrozoleNDNDND
LeuprolideNDNDND
LevamisoleNDNDND
LevobupivacaineUNDU
LevofloxacinUNDU
LevonorgestrelUNDU
LevorphanolNDNDND
LevothyroxineUNDU
LidocaineNoNDU
LincomycinNoNDNo
LisinoprilYesLND
LithiumYesLYes
LomefloxacinNoNDNo
LomustineNoNDU
LoperamideNDNDND
LoracarbefYesLND
LoratadineNoNDNo
LorazepamNoNDU
LosartanNoNDNo
LovastatinUNDU
LoxapineNDNDND
MangafodipirNDNDND
MannitolYesLYes
MaprotilineNoNDU
MechlorethamineNoNDNo
MeclofenamateUNDU
Mefenamic acidNoNDU
MefloquineUNDU
MelphalanNoNDND
MeperidineNoNDU
MeprobamateYesLYes
MercaptopurineYesLND
MeropenemYesLND
Mesalamine (5-ASA)UNDU
MesnaNDNDND
MesoridazineUNDU
MetaproterenolNDNDND
MetforminYesLND
MethadoneNoNDNo
MethaqualoneNoNDNo
MethenamineNDNDND
MethicillinNoNDNo
MethimazoleNoNDNo
MethotrexateYesYesNo
MethyldopaYesLYes
MethylphenidateUNDU
MethylprednisoloneYesLND
MetoclopramideNoNDNo
MetolazoneNoNDU
MetoprololYesLND
MetronidazoleYesLNo
MexiletineYesLNo
MezlocillinYesLNo
MiacalcinNDNDND
MiconazoleNoNDNo
MidazolamNoNDU
Midodrine (de-glymidodrine)YesNDNA
MiglitolNDNDND
MilrinoneNDNDND
MinocyclineNoNDNo
MinoxidilYesLYes
MirtazapineUNDU
MisoprostolUNDU
MitomycinNDNDND
MitoxantroneNoNDNo
MivacuriumNDNDND
ModafinilNDNDND
MoexiprilNDNDND
MolindoneUNDU
MontelukastUNDU
MoricizineUNDU
MorphineYesNDNo
Muromonab-CD3UNDU
Mycophenolate (mycophenolic acid)NoNDNo
NabumetoneNoNDND
NadololYesLND
NafcillinNoNDNo
NalmefeneNoNDU
NaloxoneNDNDND
NaltrexoneNDNDND
NaproxenNoNDU
NaratriptanNDNDND
NefazodoneUNDU
NelfinavirUNDU
NetilmicinYesLYes
NevirapineNDNDND
NicardipineNoNDU
NicotineNDNDND
Nicotinic acidNDNDND
NifedipineNoNDNo
NilutamideNDNDND
NimodipineNoNDNo
NisoldipineNoNDNo
NitrendipineNoNDU
NitrofurantoinYesLND
NitroglycerinNoNDNo
NitroprussideYesLYes
NizatidineNoNDNo
NomifensineNDNDND
NorethindroneNDNDNo
NorfloxacinNoNDU
NortriptylineNoNDNo
OctreotideYesLND
OfloxacinYesNDNo
OlanzapineNoNDNo
OlsalazineUNDU
OmapatrilatNoNDND
OmeprazoleUNDU
OndansetronUNDU
OrbofibanYesLND
OrlistatUNDU
OrnidazoleYesLNo
OrphenadrineNDNDND
OxacillinNoNDNo
OxaprozinNoNDU
OxazepamNoNDU
OxybutyninNDNDND
OxycodoneNDNDND
OxymorphoneNDNDND
PaclitaxelNoNDU
PamidronateNDNDND
PancuroniumNDNDND
PantoprazoleNoNDND
ParicalcitolNoNDND
ParoxetineNoNDU
PefloxacinNoNDNo
PegaspargaseUNDU
PemolineYesLNo
PenbutololNoNDNo
PenicillamineYesLND
Pencillin GYesLNo
PentamidineNoNDNo
PentazocineYesLND
PentobarbitalNoNDU
Pentosan polysulfateNDNDND
PentostatinNDNDND
PentoxifyllineUNDND
PergolideUNDU
Perindopril (perindoprilat)YesLND
PerphenazineUNDU
PhenelzineNDNDND
PhenobarbitalYesLYes
PhentermineNDNDND
PhentolamineNDNDND
PhenylbutazoneNoNDU
PhenylpropanolamineNDNDND
PhenytoinNoYesNo
Pimagedine (aminoguanidine)YesNDND
PimozideNDNDND
PindololNDNDND
PioglitazoneUNDU
PiperacillinYesLNo
PiroxicamUNDU
PlicamycinNDNDND
PolythiazideNoNDNo
PralidoximeNDNDND
PramipexoleNoNDU
PravastatinNoNDND
PrazepamNoNDU
PrazosinNoNDNo
PrednisoneNoNDNo
PrimidoneYesLND
ProbucolNoNDNo
ProcainamideYesLNo
ProcarbazineNDNDND
ProchlorperazineUNDU
PromazineUNDU
PromethazineNoNDND
PropafenoneNoNDNo
PropofolUNDU
PropoxypheneNoNDNo
PropranololNoNDNo
ProtriptylineNoNDNo
PseudoephedrineNoNDU
PyrazinamideYesYesNo
PyrimethamineNDNDND
QuazepamUNDU
QuetiapineNDNDND
Quinapril (quinaprilat)NoNDNo
QuinidineNoNDNo
QuinineNoNDNo
Quinupristin/dalfopristinNDNDNo
RabeprazoleUNDU
RaloxifeneUNDU
Ramipril (ramiprilat)NoNDND
RanitidineNoNDNo
RecainamNoNDU
RepaglinideUNDU
ReserpineNoNDNo
ReteplaseNDNDND
ReviparinNoNDU
RifabutinUNDU
RifampinNoNoNo
RifapentineUNDU
RilmenidineNoNDU
RimantadineNoNDU
RisperidoneNDNDND
RitodrineYesLYes
RitonavirUNDU
RizatriptanNDNDND
RocuroniumNDNDND
RofecoxibNoNDU
RopiniroleUNDU
RosiglitazoneNoNDU
RoxithromycinNDNDNo
RufloxacinNDNDND
SalsalateYesLNo
SaquinavirUNDU
SargramostimNDNDND
SecobarbitalNoNDNo
SelegilineNDNDND
SermorelinNDNDND
SertindoleNoNDND
SertralineNoNDU
SevelamerUUU
SibutramineUNDU
SildenafilUNDU
SilverNoNDU
SimvastatinUNDU
SirolimusUNDND
SisomicinYesLND
SomatropinUNDU
SotalolYesLND
SparfloxacinNDNDND
SpectinomycinYesLYes
Spirapril (spiraprilat)UNDU
SpironolactoneUNDU
StavudineNDNDND
StreptomycinYesLYes
StreptozocinNDNDND
SucralfateNoNDNo
SufentanilUNDU
SulbactamYesLNo
SulfamethoxazoleYesLNo
SulfisoxazoleYesLYes
SulindacNoNDU
SumatriptanNDNDND
TacrineNDNDND
TacrolimusNoNDU
TamoxifenNDNDND
TamsulosinUNDU
TazobactamYesLNo
TeicoplaninNoNDNo
TelmisartanUNDU
TemazepamNoNDU
TemocillinYesLNo
TeniposideUNDU
TerazosinNoNDNo
TerbinafineUNDU
TerbutalineNDNDND
TestosteroneUNDU
TetracyclineNoNDNo
ThalidomideNDNDND
TheophyllineYesLNo
ThiethylperazineNDNDND
ThioguanineNDNDND
ThioridazineUNDU
ThiotepaNDNDND
ThiothixeneUNDU
TiagabineNoNDND
TicarcillinYesLNo
TiclopidineUNDU
TiludronateUNDU
TimololNoNDNo
TinidazoleYesLND
TirofibanYesLND
TizanidineNDNDND
TobramycinYesLYes
TocainideYesLND
TolazamideUNDU
TolbutamideNoNDU
TolcaponeUNDND
TolmetinUNDU
TolterodineUNDU
TopiramateYesLND
TopotecanNDNDND
TorsemideNoNDU
TramadolNoNDU
Trandolapril (trandolaprilat)YesLND
Tranexamic acidNDNDND
TranylcypromineNDNDND
TrapidilNDNDND
TrazodoneUNDU
TretinoinNDNDND
TriamtereneNDNDND
TriazolamNoNDU
TrifluoperazineNoNDNo
TriflupromazineUNDU
TrihexyphenidylNDNDND
TrimethoprimYesLNo
TrimetrexateUNDU
TrimipramineUNDU
TroglitazoneUNDU
TropisetronUNDU
TrovafloxacinNoNDND
UrsodiolUNDU
ValacyclovirYesLND
Valproic acidNoNDNo
ValsartanUNDU
VancomycinNoYesNo
VecuroniumUNDU
VenlafaxineNoNDU
VerapamilNoNDNo
VigabatrinYesLND
VinblastineNDNDND
VincristineNDNDND
WarfarinNoNDNo
ZafirlukastUNDU
ZalcitabineNDNDND
Zidovudine/GZDVNo/YesND/LNo/Yes
ZileutonNoNDU
ZolmitriptanNDNDND
ZolpidemNoNDU

Yes– dialyzable, No-not dialyzable, U-unlikely, L-likely but no data, ND-no data, NS– no high permeability membrane specified

Sources: 

  1. Dialysis of Drugs, Nephrology Pharmacy Associates, 2000; http://www.just.edu.jo/DIC/Manuals/Dialysis%20of%20Drugs.pdf
  2.  Tox and Hound – Dialyze This, EMCrit, Aug 21, 2018; https://emcrit.org/toxhound/tox-and-hound-dialyze-this/

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