NextDose: A web-based Bayesian dose forecasting tool

 

Last updated 27 July 2021

Medicines Summary

 

Medicine

Use

Target (see Target Types)

Method

References

Busulfan

Conditioning regimen before bone marrow transplantation (neonates to adults)

Prediction of dose required to achieve the target. Target choice of

1. Average steady state concentration

mg/L (Css avg)

umol/L (Css avg)

 

2. AUC at steady state with user specified target dosing interval

umol/L*min (AUCssDI)

mg/L*h (AUCssDI)

 

3. Cumulative AUC over user selected interval

mg/L*h (cum AUC 4 days)

mg/L*h (cum AUC 2 days)

Dose predictions from trapezoidal AUC and Bayesian estimates of PK parameters.

Holford & Holford (1), Holford (2)

Gentamicin

Any indication for which gentamicin is administered intravenously (neonates to adults)

Prediction of dose required to achieve the target. Target choice of

1. Steady state average concentration

mg/L (Css avg)

2. Steady state AUC with user specified dosing interval

mg/L*h (AUCssDI)

3. Steady state concentration

mg/L (Css1h)

mg/L (Css8h)

mg/L (Css12h)

mg/L (Css24h)

mg/L (Csstrough)

Dose predictions from trapezoidal AUC and Bayesian estimates of PK parameters

Holford & Holford (1), Holford (2), Holford et al.(3)

Tobramycin

Any indication for which tobramycin is administered intravenously (neonates to adults)

Prediction of dose required to achieve the target. Target choice of

1. Steady state average concentration

mg/L (Css avg)

2. Steady state AUC with user specified dosing interval

mg/L*h (AUCssDI)

3. Steady state concentration

mg/L (Css1h)

mg/L (Css8h)

mg/L (Css12h)

mg/L (Css24h)

mg/L (Csstrough)

Dose predictions from trapezoidal AUC and Bayesian estimates of PK parameters

Holford & Holford (1), Holford (2)

Vancomycin

Any indication for which vancomycin is administered intravenously (neonates to adults)

Prediction of dose required to achieve the target. Target choice of

1. Average steady state concentration

mg/L (Css avg)

2. AUC at steady state with user specified dosing interval

mg/L*h (AUCss24)

mg/L*h (AUCssDI)

3. Steady state concentration

mg/L (Css1h)

mg/L (Css8h)

mg/L (Css12h)

mg/L (Css24h)

mg/L (Csstrough)

Dose predictions from trapezoidal AUC and Bayesian estimates of PK parameters

Holford & Holford (1), Holford (2), Holford et al.(3), Ma et al(4)

Amikacin

Any indication for which amikacin is administered intravenously (neonates to adults)

Prediction of dose required to achieve the target. Target choice of

1. Steady state average concentration

mg/L (Css avg)

2. Steady state AUC with user specified dosing interval

mg/L*h (AUCssDI)

3. Steady state concentration

mg/L (Css1h)

mg/L (Css8h)

mg/L (Css12h)

mg/L (Css24h)

mg/L (Csstrough)

Dose predictions from trapezoidal AUC and Bayesian estimates of PK parameters

Holford & Holford (1), Holford (2), Holford et al.(3)

Methotrexate

High dose methotrexate e.g. acute lymphoblastic leukemia (age> 2y)

Prediction of dose required to achieve the target AUC0-inf after a dose

umol * h (AUC0-inf)

Dose predictions from trapezoidal AUC and Bayesian estimates of clearance.

Holford & Holford (1), Holford (2), Holford et al. (5)

Warfarin

Oral anticoagulation (age > 2y)

Prediction of dose required to achieve the target average steady state INR

Dose predictions Bayesian estimates of PK and PD parameters

Holford & Holford (1), Holford (2)

Voriconazole

Any indication for which voriconazole is administered intravenously (age> 2y)

Prediction of dose required to achieve the target. Target choice of

1. Average steady state concentration

(mg/L)/(mg/L) CssAvg/MIC

2. Steady state trough concentration

(mg/L)/(mg/L) CssTrough (Css12h/MIC)

(mg/L)/(mg/L) CssTroughDI/MIC)

Dose predictions from trapezoidal AUC and Bayesian estimates of PK parameters

Holford & Holford (1), Holford (2)

Linezolid

Any indication for which linezolid is administered intravenously or orally (age> 2y)

Prediction of dose required to achieve the target AUC at steady state with user specified dosing interval.

h (AUCssDI/MIC)

Dose predictions from trapezoidal AUC and Bayesian estimates of PK parameters

Holford & Holford (1), Holford (2)

Dabigatran

Oral anticoagulation (age > 2y)

Prediction of dose required to achieve the target average steady state concentration

mg/L (Css avg)

Dose predictions from trapezoidal AUC and Bayesian estimates of PK parameters

Holford & Holford (1), Holford (2)

Caffeine

Apnea of prematurity (neonates)

Prediction of dose required to achieve the target average steady state concentration

mg/L (Css avg)

Dose predictions from trapezoidal AUC and Bayesian estimates of PK parameters

Holford & Holford (1), Holford et al (6)

Hydroxychloroquine

Anti-inflammatory indications (age> >2 y)

Prediction of dose required to achieve the target average steady state concentration

mg/L (Css avg)

Dose predictions from trapezoidal AUC and Bayesian estimates of PK parameters

Holford & Holford (1), Holford (2)

Posaconazole

Any indication for which posaconazole is administered orally (infants to adults)

Prediction of dose required to achieve the target. Target choice of

1. Average steady state concentration

(mg/L) CssAvg

2. Steady state trough concentration (mg/L)

(Css8h, Css12h)

Dose predictions from trapezoidal AUC and Bayesian estimates of PK parameters

Holford & Holford (1), Holford (2)

 

References:

1. Holford N, Holford SD. NextDose (www.nextdose.org) a web-based collaborative tool for target concentration intervention 2021 [

2. Holford NHG. NextDose A web based dosing tool Development version 2017. PAGANZ 2017 https://wwwpaganzorg/abstracts/nextdose-a-web-based-dosing-tool-development-version-2017/. 2017;Accessed 20 Feb 2017.

3. Holford NHG, Falcao AC, Debeer A, Anderson BJ, Vialet R, Simon N, et al. Prediction of renal function from premature neonates Application to neonatal vancomycin, amikacin and gentamicin pharmacokinetics with and without indomethacin and ibuprofen. In Preparation. 2011.

4. Ma G, Holford N, Hannam J, Harrison J. Vancomycin Target Concentration Intervention vs. Therapeutic Drug Monitoring. ASCEPT-PAGANZ; Queenstown2019.

5. Holford NHG, Hirankarn S, Dombrowsky E, Patel D, Barrett JS. What is the between cycle variability in methotrexate clearance? PAGE. 2012;21 (Abstr 2474):[www.page-meeting.org/?abstract=2474].

6. Holford N, Yang X, Jiang Z, Shen H, Shi J, Shu X, et al. Rational dosing of caffeine using target concentration intervention to improve treatment of apnea of prematurity Abstr 9027 [www.page-meeting.org/?abstract=9027]. PAGE. 2019;28.