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Related Concept Videos

Dosage Regimen: Individualization01:24

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Individualization in dosing regimens is the customization of medication doses for individual patients. Its necessity arises from the goal of maximizing therapeutic benefits while minimizing risks. This approach is pivotal because human responses to drugs can vary widely; what is effective for one person may be inadequate or excessive for another. Interpatient (intersubject) variability refers to differences in drug responses between individuals, while intrapatient (intrasubject) variability...
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A rational dosage regimen considers a drug's pharmacokinetics, including its absorption, distribution, metabolism, and elimination from the body. By understanding these factors, the appropriate dosage can be determined, and the dosing schedule can be designed to achieve and maintain the desired therapeutic effect while minimizing adverse effects.
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Designing a dosage regimen, which refers to the manner of drug administration, is a complex process involving the selection of drug dose, route, and frequency. This process is underpinned by pharmacokinetic parameters derived from tests and population averages. These parameters are then tailored to patient-specific variables such as diagnosis, demographics, and allergy status. Once therapy commences, therapeutic response monitoring is critical and achieved through clinical and physical...
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It is not uncommon for complete drug pharmacokinetic profiles to remain elusive in pharmacokinetics. This necessitates certain educated assumptions by pharmacokineticists to determine appropriate dosage regimens without comprehensive pharmacokinetic data from animal or human studies. One prevalent assumption is setting the bioavailability factor, denoted as F, to 1 or 100%. This assumption caters to the scenario where a drug doesn't achieve full systemic absorption, resulting in the patient...
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Combining two or more treatment methods increases the life span of cancer patients while reducing damage to vital organs or tissue from the overuse of a single treatment. Combination therapy also targets different cancer-inducing pathways, thus reducing the chances of developing resistance to treatment.
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Determining the optimal dose size and dosing frequency in pharmacotherapy is crucial for achieving therapeutic effectiveness while minimizing adverse effects. This article explores the methodologies employed in determining these parameters, focusing on their significance and interplay to tailor dosing regimens.Dose Size: Dose size refers to the amount of a drug administered in a single dose. It is determined based on the drug's pharmacodynamics and pharmacokinetics properties and...
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The Rational Basis for Personalized Treatment Using Concentration-Guided Dosing.

Nick Holford1, Zvonimir Petric2

  • 1Department of Pharmacology and Clinical Pharmacology, University of Auckland, Auckland, New Zealand ; and.

Therapeutic Drug Monitoring
|June 10, 2025
PubMed
Summary

Concentration-guided dosing (CGD) offers personalized medicine by distinguishing measurement, interpretation, and dosing steps. The target concentration approach (TCA) provides accurate, individualized drug doses for improved patient outcomes.

Keywords:
clinical pharmacologyconcentration-guided dosingtarget concentration interventiontherapeutic drug monitoring

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Area of Science:

  • Clinical Pharmacology
  • Pharmacometrics
  • Drug Therapy Optimization

Background:

  • Existing terminology like therapeutic drug monitoring (TDM) and model-informed precision dosing (MIPD) can be imprecise.
  • Concentration-guided dosing (CGD) principles offer a rational framework for personalized dosing strategies.
  • Accurate terminology is crucial for distinguishing drug concentration measurement, interpretation, and individualized dose prediction.

Purpose of the Study:

  • To encourage precise terminology in drug dosing.
  • To explain and promote concentration-guided dosing (CGD) principles.
  • To highlight the evolution of accurate terminology in individualized drug dose guidance.

Main Methods:

  • Literature search using keywords: TDM, therapeutic range, individualized dosing, target concentration intervention, precision dosing, MIPD, and personalized dosing.
  • Inclusion of studies addressing theoretical basis, clinical implementation, and effectiveness of CGD.
  • Synthesis of findings to emphasize CGD's relevance in clinical pharmacology.

Main Results:

  • Concentration-guided dosing (CGD) is often implemented via therapeutic window approach (TWA) or target concentration approach (TCA).
  • Therapeutic drug monitoring (TDM) and model-informed precision dosing (MIPD) lack specified dosing approaches.
  • Clinicians traditionally favor TWA as the standard for personalized dosing.

Conclusions:

  • Target concentration approach (TCA) provides accurate, personalized treatment by optimizing drug dosage for safety and efficacy.
  • Understanding and adoption of TCA benefits are currently limited among clinicians.
  • TCA guides clinical teams toward optimal and safe individualized dosing for each patient.