Related Experiment Video
Updated: Aug 24, 2026
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Drug dosing in children with obesity: a narrative updated review
Francesca Gaeta1, Valeria Conti2, Angela Pepe1
1Pediatrics Section, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, 84081, Baronissi, Salerno, Italy.
Insights
Drug dosing for children with obesity requires careful consideration beyond total body weight. Tailored approaches are essential for effective and safe pediatric pharmacotherapy in overweight and obese youth.
Area of Science:
- Pediatric pharmacology
- Obesity medicine
- Clinical therapeutics
Background:
- Childhood obesity and its comorbidities are prevalent health issues in pediatric populations.
- Standard drug dosing based on total body weight may be inadequate for children with obesity.
- Pharmacokinetic and pharmacodynamic variations in pediatric obesity necessitate specialized dosing strategies.
Purpose of the Study:
- To review current drug dosing methods for children with obesity.
- To analyze the pros and cons of various dosing strategies.
- To highlight the need for tailored therapeutic approaches in pediatric obesity.
Main Methods:
- Narrative review of existing literature on drug dosing in pediatric obesity.
- Examination of pharmacologic considerations including metabolomic profiles, pharmacokinetics, and pharmacodynamics.
- Focus on commonly prescribed medications in pediatric practice.
Main Results:
- Total body weight-based dosing may not accurately reflect drug disposition in pediatric obesity.
- Age and size variations impact drug efficacy and safety.
- Individualized dosing strategies are crucial for optimizing treatment outcomes.
Conclusions:
- Empirical weight-based drug dosing is insufficient for children with obesity.
- A tailored approach considering individual patient factors is necessary for safe and effective pharmacotherapy.
- Further research into optimized dosing regimens for pediatric obesity is warranted.
Abstract:
Childhood obesity and its associated comorbidities are highly prevalent diseases that may add to any other possible health problem commonly affecting the pediatric age. Uncertainties may arise concerning drug dosing when children with obesity need pharmacologic therapies. In general, in pediatric practice, there is a tendency to adapt drug doses to a child's total body weight. However, this method does not consider the pharmacological impact that a specific drug can have under a two-fold point of view, that is, across various age and size groups as well. Moreover, there is a need for a therapeutic approach, as much as possible tailored considering relevant interacting aspects, such as modification in metabolomic profile, drug pharmacokinetics and pharmacodynamics. Taking into account the peculiar differences between children with overweight/obesity and those who are normal weight, the drug dosage in the case of obesity, cannot be empirically determined solely by the per kg criterion. In this narrative review, we examine the pros and cons of several drug dosing methods used when dealing with children who are affected also by obesity, focusing on specific aspects of some of the drugs most frequently prescribed in real-world practice by general pediatricians and pediatric subspecialists.
Related Concept Videos
01:29Drug Dosing: Infants and Children
01:21Drug Dosing: Obese Patients
01:25Pharmacokinetics in Obese Patients: Drug Absorption and Distribution
01:20Pharmacokinetics in Obese Patients: Drug Metabolism and Excretion
01:23Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption
01:17Pharmacokinetics in Pediatric Patients: Drug Distribution