English: An anticancer drug is given to a patient at a dosage of 400 mg every day at 8:00 am. A TDM sample is obtained at 6:00 am, showing a drug concentration of 0.46 mg/L.
1) Regarding “normality”, the result is around the 25th percentile, suggesting a rather high drug clearance in this patient.
2) Regarding “appropriateness”, the result suggests that the patient’s most likely concentration curve (green dashed line) passes below the acceptance range of 0.75 to 1.5 mg/L at trough, raising concerns about treatment efficacy.
3) Regarding dosage adjustment to recommend, this TDM result suggests that a doubled dose of 800 mg daily might be suitable to drive the concentration curve close to target (blue dotted line).
Note that this interpretation assumes that the patient’s adherence to prescription is good, and that the sample measurement is accurate.
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