Drug Combination Strategy: Pharmacokinetics and Drug-Drug Interaction Considerations in Diseased Patients

The availability of fixed dose combinations (FDC) continues to be on the rise since they provide convenience and compliance for the disease management [1,2]. Given the involvement of polypharmacy in the current disease management for certain chronic ailments, the development of newer FDC combinations to benefit patients in a disease area is amply justified [3,4]. A recent publication on this important topic lays out a strategy and framework for an unequivocal and unbiased evaluation of FDC product from a pharmacokinetic perspective [5]. Some key topics of discussion in this paper includes the attributes that contribute for the dose selection of the individual FDC drug components and the key features to determine the extent (or lack) of a pharmacokinetic drug-drug interaction between the two drugs in the FDC [5]. The intent of this editorial is to provide some perspectives on the altered changes in physiology in disease patients that may likely have an influence on the pharmacokinetic disposition of drugs that are used in the combination strategy.