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REVIEW article

Front. Pharmacol.
Sec. Drug Metabolism and Transport
Volume 16 - 2025 | doi: 10.3389/fphar.2025.1546465
This article is part of the Research Topic Non-Invasive Methods in Drug Metabolism and Transport: Insights from Biological Samples to Oral Administration View all articles

Effect of Hypoalbuminemia on Drug Pharmacokinetics

Provisionally accepted
Ilona Idasiak-PIechocka Ilona Idasiak-PIechocka 1Dominik Lewandowski Dominik Lewandowski 1Wojciech Świgut Wojciech Świgut 1Jan Kalinowski Jan Kalinowski 1Klaudia Mikosza Klaudia Mikosza 1Piotr Suchowiejski Piotr Suchowiejski 1Edyta Szałek Edyta Szałek 2Agnieszka Karbownik Agnieszka Karbownik 2Miłosz Miedziaszczyk Miłosz Miedziaszczyk 1,2*
  • 1 Department of General and Transplant Surgery, Poznan University of Medical Sciences, Poznan, Poland
  • 2 Department of Clinical Pharmacy and Biopharmacy, Poznan University of Medical Sciences, Poznan, Poland

The final, formatted version of the article will be published soon.

    Hypoalbuminemia, defined as serum albumin levels below 35 g/l, is common in patients with conditions such as nephrotic syndrome, cirrhosis, or sepsis. This review examines the impact of hypoalbuminemia on the pharmacokinetics of selected drugs-such as antibiotics, immunosuppressants, antifungals, or anticonvulsants-emphasizing its role in drug efficacy and safety. Albumin is the main drug transporter and key binding protein, which influences the free drug concentration and drug activity. The review includes all studies available in the scientific literature found in the PubMed, Scopus, and Cochrane databases. The paper emphasizes the importance of therapeutic drug monitoring (TDM) in patients with hypoalbuminemia to avoid subtherapeutic or toxic drug levels. Many drugs need for dose adjustments to achieve therapeutic levels, especially in critically ill patients. The results of studies emphasize the need for individualized dosing regimens based on TDM to optimize drug therapy in patients with hypoalbuminemia. Our review is the first article to summarize the influence of hypoalbuminemia on the pharmacokinetic parameters of drugs and may be a useful tool for clinicians in their daily work.

    Keywords: Hypoalbuminemia, Drug pharmacokinetics, Nephrotic Syndrome, Protein Binding, distribution

    Received: 16 Dec 2024; Accepted: 27 Jan 2025.

    Copyright: © 2025 Idasiak-PIechocka, Lewandowski, Świgut, Kalinowski, Mikosza, Suchowiejski, Szałek, Karbownik and Miedziaszczyk. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Miłosz Miedziaszczyk, Department of General and Transplant Surgery, Poznan University of Medical Sciences, Poznan, Poland

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.