Altered Drug Disposition in Obesity and After Bariatric Surgery

Abstract

The purpose of this review is to evaluate the effect of obesity and gastric bypass on drug disposition. A Medline search was conducted of literature from 1980 onward. All types of literature were included because of the limited data published on this subject. Very few prospective randomized controlled studies are available that have evaluated changes in drug pharmacokinetics and pharmacodynamics in patients who have a body mass index (BMI) >40 kg/m² or who have undergone gastric restrictive surgery. Dosing recommendations have been based on general pharmacokinetic principles where specific drug data have not been assessed. Given the increasing prevalence of overweight and obesity in the population, studies that evaluate the impact of obesity on drug disposition, especially related to drugs released in the past 10 years, should be conducted.