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British Journal of Pharmacology
Article . 2009 . Peer-reviewed
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To scale or not to scale: the principles of dose extrapolation

Authors: Vijay, Sharma; John H, McNeill;

To scale or not to scale: the principles of dose extrapolation

Abstract

The principles of inter‐species dose extrapolation are poorly understood and applied. We provide an overview of the principles underlying dose scaling for size and dose adjustment for size‐independent differences. Scaling of a dose is required in three main situations: the anticipation of first‐in‐human doses for clinical trials, dose extrapolation in veterinary practice and dose extrapolation for experimental purposes. Each of these situations is discussed. Allometric scaling of drug doses is commonly used for practical reasons, but can be more accurate when one takes into account species differences in pharmacokinetic parameters (clearance, volume of distribution). Simple scaling of drug doses can be misleading for some drugs; correction for protein binding, physicochemical properties of the drug or species differences in physiological time can improve scaling. However, differences in drug transport and metabolism, and in the dose–response relationship, can override the effect of size alone. For this reason, a range of modelling approaches have been developed, which combinein silicosimulations with data obtainedin vitroand/orin vivo. Drugs that are unlikely to be amenable to simple allometric scaling of their clearance or dose include drugs that are highly protein‐bound, drugs that undergo extensive metabolism and active transport, drugs that undergo significant biliary excretion (MW > 500, ampiphilic, conjugated), drugs whose targets are subject to inter‐species differences in expression, affinity and distribution and drugs that undergo extensive renal secretion. In addition to inter‐species dose extrapolation, we provide an overview of dose extrapolation within species, discussing drug dosing in paediatrics and in the elderly.

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Keywords

Dose-Response Relationship, Drug, Age Factors, Drug Evaluation, Preclinical, Drug Delivery Systems, Pharmaceutical Preparations, Species Specificity, Models, Animal, Practice Guidelines as Topic, Animals, Humans

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
442
Top 0.1%
Top 1%
Top 10%
bronze