When is TDM Not Useful?

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When is TDM Not Useful?

TDM is also not useful in these specific situations:
  • For drugs which act intracellularly, or that need to be converted to active forms (like AZT).
  • For drugs in which the effects last much longer than the serum concentrations of the drugs; examples include antineoplastics (cancer chemotherapies) and warfarin.
  • Narcotic pain medications in which continued use can lead to tolerance such that the levels needed for pain relief in one person would be toxic to another person.