Effect of laparoscopic sleeve gastrectomy on drug pharmacokinetics

Expert Rev Clin Pharmacol. 2021 Oct 25. doi: 10.1080/17512433.2021.1997585. Online ahead of print.ABSTRACTINTRODUCTION: Given its feasibility and efficacy, laparoscopic sleeve gastrectomy (LSG) has become a widely accepted bariatric surgery for patients with clinically diagnosed severe obesity. LSG induces anatomical changes and subsequent weight loss which may affect drug pharmacokinetics (PK) and consequently impact dosing regimens. This review aims to examine the effect of LSG on drug PK and identify relevant gastrointestinal physiological alterations.AREAS COVERED: PubMed, Embase, Scopus, and the Cochrane Library were searched for articles related to drug PK and LSG from inception to July 2021. Moreover, literature concerning postoperative physiological conditions in the gastrointestinal tract, such as gastric pH, gastric emptying, and small bowel transit time, etc., which may affect the PK profile of drug products was also reviewed.EXPERT OPINION: Although LSG is classified as having restrictive property without malabsorptive bypass, postoperative changes in gastrointestinal physiology and subsequent weight loss may also lead to increased, decreased, unaltered, or unpredictable drug exposure levels. General monitoring on drug efficacy or safety using biomarkers of clinical makers is proposed. In addition, therapeutic drug monitoring for those drugs when it is applicable and available is recommended to ensure efficient drug dosing and avoid adverse effects. Further resear...
Source: Expert Review of Clinical Pharmacology - Category: Drugs & Pharmacology Authors: Source Type: research