ISSUES AND PERSPECTIVES OF ADJUSTMENT OF DRUG DOSAGES FOR PEDIATRIC, GERIATRIC, IMMUNOSUPPRESSED, AND CANCER PATIENTS

Dr. Shankar Prasad Bhattacharya*

Individualizing drug dosages is a critical component of modern clinical pharmacology, particularly in vulnerable populations such as pediatric, geriatric, immunosuppressed, and cancer patients. Physiological and pharmacokinetic differences across these groups—due to age-related developmental changes, organ function impairment, immune system variability, and disease-specific drug responses—pose significant challenges for safe and effective drug therapy. Standard “fixed” dosing regimens derived from adult clinical trials often fail to account for such variability, increasing the risk of therapeutic failure or adverse drug reactions. Precision dosing and model-informed approaches have emerged as promising methods to address these challenges by integrating patient-specific factors with pharmacokinetic/pharmacodynamic data. This paper reviews key issues, including developmental pharmacology, age-associated physiological changes, immunosuppressant therapeutic monitoring, and oncology drug optimization, while presenting clinical and research perspectives for improving dosing guidelines and patient outcomes.