Pharmacokinetic principles of dose adjustment of mTOR inhibitors in solid organ transplanted patients

What Is Known and Objectives mTOR inhibitors possess narrow therapeutic range and substantial pharmacokinetic variability and the consequences from suboptimal dosing are serious. The aim of this review is to summarize the current knowledge about the factors influencing mTOR inhibitors pharmacokinetics and the possibility of using these relationships in order to improve its therapy individualization in solid organ transplanted patients. Methods Literature search from Pubmed and Web of Science databases were performed using Boolean search operators in order to identify relevant studies. Results and Discussion A total of 701 reports were identified from the initial literature search. Out of which 40 studies dealt with relationships between various factors and pharmacokinetics of mTOR inhibitors and with relevance of these associations for dosage optimization. What Is New and Conclusion The overview of the current covariates for pharmacokinetic variability of mTOR inhibitors has been provided on the level of absorption, distribution and elimination, and consequences of these relationships for dosing optimization has been summarized. The overview of the current covariates for pharmacokinetic variability of mTOR inhibitors sirolimus and everolimus has been provided and consequences of these relationships for dosing optimization has been summarized.