Conclusions
Bariatric surgery is increasingly employed for (morbid) obesity because
it improves long-term morbidity and mortality. As a result of changes in
the gastrointestinal tract that subsequently result in major weight
loss, the pharmacokinetics of drugs in patients after bariatric surgery
may be subject to alterations in the absorption, distribution,
metabolism, and/or elimination. Due to an increased absorption rate
after bariatric surgery, the time at maximum concentration is often
earlier and the maximum concentration may be higher with less consistent
effects on trough concentrations and exposure or area under the curve
upon oral drug administration. We conclude that based on current
literature an advice can be proposed in many cases but also that there
is insufficient evidence for general dosing recommendations for oral
drug therapy after bariatric surgery implying a risk assessment on a
case by case basis.