Impact of Bariatric Surgery in the Short and Long Term: A Need for Time-Dependent Dosing of Drugs

Cedric Lau; Charlotte van Kesteren; Robert Smeenk; Alwin Huitema; Catherijne A.J. Knibbe

doi:10.1007/s11695-023-06770-5

Impact of Bariatric Surgery in the Short and Long Term: A Need for Time-Dependent Dosing of Drugs

Cedric Lau^*
, Charlotte van Kesteren
, Robert Smeenk
, Alwin Huitema
, Catherijne A.J. Knibbe

^*Corresponding author for this work

Research output: Contribution to journal › Review article › peer-review

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Abstract

Sparse information is available on pharmacokinetic changes of drugs over time after bariatric surgery. By reviewing the literature on the short- and long-term pharmacokinetic changes of drugs, several patterns were identified for 39 drugs. No relevant pharmacokinetic changes were identified for roughly a third of the drugs. Of the remaining drugs, levels were variable and partly unpredictable shortly after the surgery. In the long term, most of the drug levels remain altered, but in some cases they returned to preoperative values. Based on the changes and the efficacy-safety balance of each drug, clinicians may need to perform additional clinical monitoring for specific drugs, including measuring drug levels. This review provides suggestions for clinicians and pharmacists for specific time-dependent drug dosing advice.

Original language	English
Pages (from-to)	3266-3302
Number of pages	37
Journal	Obesity Surgery
Volume	33
Issue number	10
DOIs	https://doi.org/10.1007/s11695-023-06770-5
Publication status	Published - Oct 2023

Keywords

Bariatric surgery
Pharmacokinetics
Roux-en-Y gastric bypass
Sleeve gastrectomy

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title = "Impact of Bariatric Surgery in the Short and Long Term: A Need for Time-Dependent Dosing of Drugs",

abstract = "Sparse information is available on pharmacokinetic changes of drugs over time after bariatric surgery. By reviewing the literature on the short- and long-term pharmacokinetic changes of drugs, several patterns were identified for 39 drugs. No relevant pharmacokinetic changes were identified for roughly a third of the drugs. Of the remaining drugs, levels were variable and partly unpredictable shortly after the surgery. In the long term, most of the drug levels remain altered, but in some cases they returned to preoperative values. Based on the changes and the efficacy-safety balance of each drug, clinicians may need to perform additional clinical monitoring for specific drugs, including measuring drug levels. This review provides suggestions for clinicians and pharmacists for specific time-dependent drug dosing advice.",

keywords = "Bariatric surgery, Pharmacokinetics, Roux-en-Y gastric bypass, Sleeve gastrectomy",

author = "Cedric Lau and \{van Kesteren\}, Charlotte and Robert Smeenk and Alwin Huitema and Knibbe, \{Catherijne A.J.\}",

note = "Publisher Copyright: {\textcopyright} 2023, The Author(s).",

year = "2023",

month = oct,

doi = "10.1007/s11695-023-06770-5",

language = "English",

volume = "33",

pages = "3266--3302",

journal = "Obesity Surgery",

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T1 - Impact of Bariatric Surgery in the Short and Long Term

T2 - A Need for Time-Dependent Dosing of Drugs

AU - Lau, Cedric

AU - van Kesteren, Charlotte

AU - Smeenk, Robert

AU - Huitema, Alwin

AU - Knibbe, Catherijne A.J.

PY - 2023/10

Y1 - 2023/10

N2 - Sparse information is available on pharmacokinetic changes of drugs over time after bariatric surgery. By reviewing the literature on the short- and long-term pharmacokinetic changes of drugs, several patterns were identified for 39 drugs. No relevant pharmacokinetic changes were identified for roughly a third of the drugs. Of the remaining drugs, levels were variable and partly unpredictable shortly after the surgery. In the long term, most of the drug levels remain altered, but in some cases they returned to preoperative values. Based on the changes and the efficacy-safety balance of each drug, clinicians may need to perform additional clinical monitoring for specific drugs, including measuring drug levels. This review provides suggestions for clinicians and pharmacists for specific time-dependent drug dosing advice.

AB - Sparse information is available on pharmacokinetic changes of drugs over time after bariatric surgery. By reviewing the literature on the short- and long-term pharmacokinetic changes of drugs, several patterns were identified for 39 drugs. No relevant pharmacokinetic changes were identified for roughly a third of the drugs. Of the remaining drugs, levels were variable and partly unpredictable shortly after the surgery. In the long term, most of the drug levels remain altered, but in some cases they returned to preoperative values. Based on the changes and the efficacy-safety balance of each drug, clinicians may need to perform additional clinical monitoring for specific drugs, including measuring drug levels. This review provides suggestions for clinicians and pharmacists for specific time-dependent drug dosing advice.

KW - Bariatric surgery

KW - Pharmacokinetics

KW - Roux-en-Y gastric bypass

KW - Sleeve gastrectomy

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DO - 10.1007/s11695-023-06770-5

M3 - Review article

C2 - 37594672

AN - SCOPUS:85168349181

SN - 0960-8923

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JO - Obesity Surgery

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IS - 10

ER -

Impact of Bariatric Surgery in the Short and Long Term: A Need for Time-Dependent Dosing of Drugs

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