Drug titration

Drug titration is the process of adjusting the dose of a medication for the maximum benefit without adverse effects.^[1]

When a drug has a narrow therapeutic index, titration is especially important, because the range between the dose at which a drug is effective and the dose at which side effects occur is small.^[2] Some examples of the types of drugs commonly requiring titration include insulin, anticonvulsants, blood thinners, anti-depressants, and sedatives.^[3]^[4]^[5]

Titrating off of a medication instead of stopping abruptly is recommended in some situations. Glucocorticoids should be tapered after extended use to avoid adrenal insufficiency.^[6]

Drug titration is also used in phase I of clinical trials. The experimental drug is given in increasing dosages until side effects become intolerable.^[7] A clinical trial in which a suitable dose is found is called a dose-ranging study.

References

^ Maxwell S (2013). "Chapter 2: Therapeutics and Good Prescribing: Choosing a Dosing Regime". In Walker BR, Colledge NR, Ralston SH, Penman ID (eds.). Davidson's Principles and Practice of Medicine. Elsevier Health Sciences. p. 34. ISBN 978-0-7020-5103-6.
^ Schachter M, Pirmohamed M (2012). "General Pharmacology". In Bennett PN, Brown MJ, Sharma P (eds.). Clinical Pharmacology (11 ed.). Elsevier. pp. 74–109. ISBN 978-0-7020-4084-9.
^ Roden DM (2014). "Chapter 5 : Principles of Clinical Pharmacology". In Kasper D, Fauci A, Hauser S, Longo D, Jameson JL, Loscalzo J (eds.). Principles of Clinical Pharmacology (19th ed.). New York, NY: McGraw-Hill. ISBN 978-0-07-180215-4.
^ Olson KR, Anderson IB, Benowitz NL, Blanc PD, Clark RF, Kearney TE, Kim-Katz SY, Wu AH, eds. (11 December 2017). "Section III: Therapeutic Drugs and Antidotes". Poisoning & Drug Overdose (7th ed.). New York, NY: McGraw-Hill. ISBN 978-0-07-183979-2.
^ Kruidering-Hall M, Campbell L (30 November 2017). "Chapter 27: Skeletal Muscle Relaxants". In Katzung BG (ed.). Basic & Clinical Pharmacology (14th ed.). New York, NY: McGraw-Hill. ISBN 978-1-259-64115-2.
^ Furst DE, Saag KG. "Glucocorticoid withdrawal". In Matteson EL, Curtis MR (eds.). Treatment Issues in Rheumatology. Retrieved 13 June 2018. {{cite book}}: |website= ignored (help)
^ "Dose-Response Information to Support Drug Registration" (PDF). Guideline for Industry. FDA. November 1994. Retrieved 13 June 2018.

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[1] Maxwell S (2013). "Chapter 2: Therapeutics and Good Prescribing: Choosing a Dosing Regime". In Walker BR, Colledge NR, Ralston SH, Penman ID (eds.). Davidson's Principles and Practice of Medicine. Elsevier Health Sciences. p. 34. ISBN 978-0-7020-5103-6.

[2] Schachter M, Pirmohamed M (2012). "General Pharmacology". In Bennett PN, Brown MJ, Sharma P (eds.). Clinical Pharmacology (11 ed.). Elsevier. pp. 74–109. ISBN 978-0-7020-4084-9.

[3] Roden DM (2014). "Chapter 5 : Principles of Clinical Pharmacology". In Kasper D, Fauci A, Hauser S, Longo D, Jameson JL, Loscalzo J (eds.). Principles of Clinical Pharmacology (19th ed.). New York, NY: McGraw-Hill. ISBN 978-0-07-180215-4.

[4] Olson KR, Anderson IB, Benowitz NL, Blanc PD, Clark RF, Kearney TE, Kim-Katz SY, Wu AH, eds. (11 December 2017). "Section III: Therapeutic Drugs and Antidotes". Poisoning & Drug Overdose (7th ed.). New York, NY: McGraw-Hill. ISBN 978-0-07-183979-2.

[5] Kruidering-Hall M, Campbell L (30 November 2017). "Chapter 27: Skeletal Muscle Relaxants". In Katzung BG (ed.). Basic & Clinical Pharmacology (14th ed.). New York, NY: McGraw-Hill. ISBN 978-1-259-64115-2.

[6] Furst DE, Saag KG. "Glucocorticoid withdrawal". In Matteson EL, Curtis MR (eds.). Treatment Issues in Rheumatology. Retrieved 13 June 2018. {{cite book}}: |website= ignored (help)

[7] "Dose-Response Information to Support Drug Registration" (PDF). Guideline for Industry. FDA. November 1994. Retrieved 13 June 2018.

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See also

References