Selection of dosages

The NOEL depends greatly on the selection of dosage levels unless the selected dosage is just below the threshold for detectable effects, the reported NOEL is an underestimate thus, tightly spaced dosage levels favor the determination of a higher NOEL. 

Serajuddin, A. T. M., A. B. Thakur, R. N. Ghoshal, M. G. Fakes, S. A. Ranadive, K. R. Morris, and S. A. Varia. 1999. Selection of dosage form composition through drug-excipient compatibility testing. 

The goals of maintenance immunosuppression are to further aid in preventing acute rejection episodes and to optimize patient and graft survival Anti-rejection medications require careful selection and dosage titration to balance the risks of rejection with the risks of adverse events. Common maintenance immunosuppressive agents can be divided into four basic medication classes ... 

Drug absorption is highly variable in neonates and infants [21,22]. Older children appear to have absorption patterns similar to adults unless chronic illness or surgical procedures alter absorption. Differences in bile excretion, bowel length, and surface area probably contribute to the reduced bioavailability of cyclosporine seen in pediatric liver transplant patients [22a]. Impaired absorption has also been observed in severely malnourished children [22b]. A rapid GI transit time may contribute to the malabsorption of carbamazepine tablets, which has been reported in a child [23]. Selection of a more readily available bioavailable dosage form, such as chewable tablets or liquids, should be promoted for pediatric patients. 

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