Drug titration explained

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.

See also

• Therapeutic drug monitoring
• Pituri – chewed as a stimulant (or, after extended use, a depressant) by Aboriginal Australians

Notes and References

1. Book: Maxwell S . Walker BR, Colledge NR, Ralston SH, Penman ID . Chapter 2: Therapeutics and Good Prescribing: Choosing a Dosing Regime . Davidson's Principles and Practice of Medicine . 2013 . Elsevier Health Sciences . 978-0-7020-5103-6 . 34 . https://books.google.com/books?id=W-5kAgAAQBAJ&pg=PA34 .
2. Book: Schachter M, Pirmohamed M. Bennett PN, Brown MJ, Sharma P . General Pharmacology . Clinical Pharmacology . 2012 . Elsevier . 74–109 . 11 . 978-0-7020-4084-9 .
3. Book: Roden DM . Chapter 5 : Principles of Clinical Pharmacology . Kasper D, Fauci A, Hauser S, Longo D,Jameson JL, Loscalzo J . Principles of Clinical Pharmacology . 19th . 978-0-07-180215-4 . New York, NY . McGraw-Hill . 2014 .
4. Book: Olson KR, Anderson IB, Benowitz NL, Blanc PD, Clark RF, Kearney TE, Kim-Katz SY, Wu AH . Section III: Therapeutic Drugs and Antidotes . Poisoning & Drug Overdose . 11 December 2017 . 7th . 978-0-07-183979-2 . New York, NY . McGraw-Hill .
5. Book: Kruidering-Hall M, Campbell L . Chapter 27: Skeletal Muscle Relaxants . Katzung BG . Basic & Clinical Pharmacology . 30 November 2017 . 14th . New York, NY . McGraw-Hill . 978-1-259-64115-2 .
6. Book: Furst DE, Saag KG . Matteson EL, Curtis MR . Glucocorticoid withdrawal . Treatment Issues in Rheumatology . https://www.uptodate.com/contents/glucocorticoid-withdrawal . UpToDate . 13 June 2018.
7. Web site: Dose-Response Information to Support Drug Registration . November 1994 . Guideline for Industry . FDA . 13 June 2018.