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No dose adjustment is required in patients with mild (CrCl 60 to 90 mL/min) or moderate (CrCl 30 to 60 mL/min) renal impairment

you can safely utilize standard supplemental doses to maximize your systemic defenses during periods of high stress

So the ladder below adjusts frequency, technique, and adherence first, and only ever revisits the schedule never invents a bigger dose