Correct Dosing Resource Index
Here are the resources we have produced to guide you in your practice.
There are three main types of resource on this site:
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Full Bibliography
Download the complete set of citations used in our research. Available in PDF format.
Dose Tables
The dose tables on this site are all available to subscribers to download in PDF format.
Psychotropic Dosing
Effective dose 50% (ED50) = the mean population dose necessary to achieve half the maximum (Emax) possible drug effect. ED50 was estimated from comparative dosing based on reductions in anxiety & related measures and published PET-serotonin transporter EC50 data.
Psychotropics are antagonists and so the mid-part of the dose-response curve plateaus, in contrast to adverse events which continue to increase.
Opioid Dosing
Effective dose 50% (ED50) = the mean population dose necessary to achieve half the maximum (Emax) possible opioid effect, was estimated from published dose response data and based on estimates of analgesic efficacy.
Being u-receptor agonists, the mid-part of the dose-response curve is exponential, doses should be increased with care.
COX-I Dosing
Effective dose 50% (ED50) = the mean population dose necessary to achieve half the maximum (Emax) possible drug effect. ED50 was estimated from published analgesic dose response data (aspirin & paracetamol based on human dose-response data, others on comparative animal work).
Being prostaglandin synthetase antagonists, the mid-part of their dose-benefit curve plateaus, and in contrast a wide range of adverse events continue to increase.
Oral Hypoglycaemic Dosing
Effective dose 50% (ED50) = the mean population dose necessary to achieve half the maximum (Emax) possible hypoglycaemic effect was based on published dose response data.
Being antagonists, the mid-part of the dose-benefit curve plateaus, but in contrast, a wide range of adverse events continue to increase.
Antihypertensive Drug Dosing
Cardiovascular drugs should usually be started around ED50, lower doses are safer and often sufficient, especially in combinations.
Effective dose 50%, ED50 = the mean population dose necessary to achieve half the maximum (Emax) possible drug effect. ED50 was estimated from published dose response data and based on reduction of BP (and with beta-blockers, HR) and thereby hopefully heart failure and other CV outcomes.
Statin dosing
Statin dosing can start and is usually sufficient around ED50.
Effective dose 50%, ED50 = the mean population dose necessary to achieve half the maximum (Emax) possible HMG CoA reductase inhibition. ED50 was estimated from published systematic reviews with dose response data of reductions in low density lipoprotein (LDL)-cholesterol and thereby hopefully coronary events.
Reviews
Reviews will be published here. Each of them will be available in PDF format.
Drug combinations? Polypill
Drug combinations - ? Polypill
The young physician starts life with 20 drugs for each disease, and the old physician ends life with one drug for 20 diseases -William Osler
Drugs must often be prescribed together for the same, related or different indications. Such will always risk interactions, in particular re competition for uptake/actions in the target organ/tissues and for elimination from the body.
Dose Response
Along with the desired clinical benefit, prescribed drugs necessarily cause a variety of unintended effects, some of which may impair quality of life, cause harms, or prove fatal. The risk of all of these effects naturally increases with dose. Higher doses are inevitably less safe and should be specifically warranted, e.g. with (all) steroids.
Reduction of significant symptoms, like shortness of breath, angina or pain are obviously important goals. However, symptoms relief is rarely complete before significant toxicities emerge.
In prevention, much is made of the ‘control’ of surrogate measures like cholesterol and glucose concentrations or blood pressure levels. However, increasing data from large clinical trials clarifies which drugs and doses are necessary with respect to the major clinical outcomes, in particular mortality.