Points to consider before making a dose modification:
A variety of interrelated factors influence the absorption, distribution, metabolism and elimination of anticancer medicines and as yet, there is no way to accurately predict the disposition of these medicines in a given individual. This means that the efficacy and toxicity of anticancer medicines will differ between individuals. Factors to consider when determining the dose of anticancer medicines include physiological factors (eg age, performance status), organ dysfunction, genetic factors which influence drug metabolism and co-administered medications (eg St John's Wort, anti-depressants).
The recommendations made in eviQ regarding dose modification are intended as a guide and are generally conservative, placing a greater weight on safety compared to efficacy. It should be noted however, that dose modifications which are intended to improve the safety profile of a drug may compromise the efficacy of the regimen. Dose escalations may be considered if no side effects are experienced following the administration of a dose reduced regimen. The exception to this rule applies if a dose reduction was made because of haematological toxicity or dose limiting cumulative toxicity.
For further information on renal or hepatic dose modifications please see below:
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25 May 2019