Influence of fever on pharmacokinetics of drugs

Abstract In humans, inflammation or exposure to exogenous stimuli in the form of an invasion by pathogenic microorganisms induces a febrile state associated and accompanied by numerous physiologic alterations, several of which have the potential to influence the pharmacokinetics (PK) of externally administered drugs. Febrile subjects may differ from afebrile subjects in how they respond to certain drugs. The intensity and extent of PK alterations may vary depending upon an invading microorganism or a bacterial toxin. Despite its significant importance in managing patients with febrile illnesses, the effect of fever on PK and pharmacodynamics has received limited attention in the clinical literature. Although not conclusive, multiple investigations have examined the influence of fever on drug PK. This chapter aims to shed light on the often-ignored yet clinically important aspect of the effects of fever on drug PK by discussing multiple case studies and recent publications.