Age-related changes in pharmacokinetics and pharmacodynamics: basic principles and practical applications
Article first published online: 14 NOV 2003
British Journal of Clinical Pharmacology
Volume 57, Issue 1, pages 6–14, January 2004
How to Cite
Mangoni, A. A. and Jackson, S. H. D. (2004), Age-related changes in pharmacokinetics and pharmacodynamics: basic principles and practical applications. British Journal of Clinical Pharmacology, 57: 6–14. doi: 10.1046/j.1365-2125.2003.02007.x
- Issue published online: 16 DEC 2003
- Article first published online: 14 NOV 2003
- Received 17 October 2002, accepted 27 February 2003.
Advancing age is characterized by impairment in the function of the many regulatory processes that provide functional integration between cells and organs. Therefore, there may be a failure to maintain homeostasis under conditions of physiological stress. The reduced homeostatic ability affects different regulatory systems in different subjects, thus explaining at least partly the increased interindividual variability occurring as people get older. Important pharmacokinetic and pharmacodynamic changes occur with advancing age. Pharmacokinetic changes include a reduction in renal and hepatic clearance and an increase in volume of distribution of lipid soluble drugs (hence prolongation of elimination half-life) whereas pharmacodynamic changes involve altered (usually increased) sensitivity to several classes of drugs such as anticoagulants, cardiovascular and psychotropic drugs. This review focuses on the main age-related physiological changes affecting different organ systems and their implications for pharmacokinetics and pharmacodynamics of drugs.