[Pharmacokinetic alterations in pregnancy and use of therapeutic drug monitoring]

Therapie. May-Jun 2014;69(3):223-34. doi: 10.2515/therapie/2014026. Epub 2014 Jul 14.
[Article in French]


Following the thalidomide tragedy, pharmacological research in pregnant women focused primarily on drug safety for the unborn child and remains only limited regarding the efficacy and safety of treatment for the mother. Significant physiological changes during pregnancy may yet affect the pharmacokinetics of drugs and thus compromise its efficacy and/or safety. Therapeutic drug monitoring (TDM) would maximize the potential effectiveness of treatments, while minimizing the potential risk of toxicity for the mother and the fetus. At present, because of the lack of concentration-response relationship studies in pregnant women, TDM can rely only on individual assessment (based on an effective concentration before pregnancy) and remains reserved only to unexpected situations such as signs of toxicity or unexplained inefficiency.

Publication types

  • English Abstract
  • Review

MeSH terms

  • Drug Monitoring / methods*
  • Female
  • Fetus / drug effects
  • Humans
  • Pharmaceutical Preparations / administration & dosage
  • Pharmaceutical Preparations / metabolism
  • Pharmacokinetics*
  • Pregnancy / metabolism
  • Pregnancy Complications / drug therapy*


  • Pharmaceutical Preparations