Weight Adjusted Dosing

Weight-Adjusted Dosing
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Weight-Adjusted Dosing
The CDC points out that over one-third, equivalent to 36.5% of the adult population in the United States is obese (Centers for Diseases Control and Prevention, 2017). Due to these findings, there is a need to adopt the administering of drugs based on the body mass index or body surface area. It has been established that using the fixed-dosing regimen is more convenient as compared to the weight-adjusted dosing schedule for both the care providers and the patients. However, the weight-adjusted regimen promotes safety and efficacy as compared to the fixed-dosing treatment when it comes to a certain population or medication. Even though the weight-adjusted dosing criterion is challenging to use, the question to answer is whether it should be adopted when administering OTC and prescription medication in the US due to the high population of obese individuals.
The Pros/Cons of Weight-Adjusted Dosing
The safety of weight-adjusted dosing will depend on the type of drug used and the age of the patient. Medication errors are likely to arise when weight-based dosages are used for prescription medication. The medication errors are likely to cause overdose hence questioning the safety of weight-adjusted dosing. For instance, an obese 8-year old weighing 90 kg with a prescription of 100mg/kg/day ceftriaxone will have to take a 9-g dose instead of the recommended 4 g/day dose (Matson, Horton, Capino, & Advocacy Committee for the Pediatric Pharmacy Advocacy Group, 2017).

However, the medication error can be corrected when the clinician administers a dose that does not exceed the recommended adult dose. Medication errors are frequently reported in children hence indicating that weight-adjusted dosing can be applied in obese adults without the possibility of having medication errors. Therefore, weight-adjusted dosing promotes safety when the recommended adult dose is not exceeded and when the patient’s weight is appropriate for the regimen.
Efficacy is defined as the ability to produce the desired effect. Administering weight-adjusted dosages are thought to promote effectiveness, but it should be noted that the effectiveness of certain medication is not only reliant on weight. The efficacy of a drug is impacted by factors such as frequency, formulation form, route, drug-drug interaction, genetics, body weight, pregnancy, food-drug interaction, pregnancy, smoking, pathophysiology status, and comorbidities (Pan et al., 2016). Therefore, weight-adjusted dosing may not promote efficacy at all times since other factors determine the effectiveness of a drug.
It is much easier for clinicians and patients to use the fixed-dose treatments as compared to the adjusted-weight dosing. It is quite challenging to administer drugs in obese patients since the fixed-dose treatments use pharmacokinetic data obtained from individuals with normal weight hence making it possible for clinicians to make mistakes when determining the appropriate doses for prescription or OTC drugs. Therefore, when administering drugs based on weight, clinicians should have up-to-date knowledge on how dosage with regards to weight. Weight-based dosing is a challenging issue since there are poor awareness and adherence regarding giving proper dosages.
Weight-adjusted dosing is expected to interfere with the cost of prescription or OTC medication. If drugs are to be administered by weight, then the cost of medication is likely to be high for obese individuals since weight determines the dosages and they may exceed the fixed-dose regimens.
Conclusion
The weight-adjusted dosing has been shown to promote safety and efficacy as compared to fixed-dose treatment. However, the effectiveness of this approach is determined by the level of know-how with regards to this subject matter. Further, it has been ascertained that clinicians and patients prefer the fixed-dose treatment to weight-adjusted treatment due to its appropriateness. Even with the high population of obese individuals, adopting the weight-adjusted dosing might be difficult in the US since it is a challenging approach to use and it is not convenient for both the patients and the clinicians.
References
Centers for Diseases Control and Prevention. (2017, August 29). Adult Obesity Facts | Overweight & Obesity | CDC. Retrieved from https://www.cdc.gov/obesity/data/adult.html
Matson, K. L., Horton, E. R., Capino, A. C., & on behalf of the Advocacy Committee for the Pediatric Pharmacy Advocacy Group. (2017). Medication Dosage in Overweight and Obese Children. The Journal of Pediatric Pharmacology and Therapeutics : JPPT, 22(1), 81–83. http://doi.org/10.5863/1551-6776-22.1.81
Pan, S., Zhu, L., Chen, M., Xia, P., & Zhou, Q. (2016). Weight-based dosing in medication use: what should we know? Patient Preference and Adherence, 10, 549–560. http://doi.org/10.2147/PPA.S103156