Pulsdosis

Pulsdosis is a pharmacological dosing strategy in which a medication is administered in discrete pulses or bursts, with drug-free intervals or reduced dosing between pulses. This contrasts with continuous infusion or steady, evenly spaced dosing. The approach leverages pharmacokinetic and pharmacodynamic properties of a drug to achieve high peak concentrations when needed while allowing system clearance during the interval, potentially reducing cumulative toxicity and the development of tolerance or receptor desensitization.

Applications have been explored in several fields. In endocrinology, pulsatile administration of gonadotropin-releasing hormone (GnRH) is used to stimulate the pituitary-gonadal axis in infertility treatments. In infectious disease and antibiotic therapy, pulse dosing—large intermittent doses with drug-free periods—has been studied to optimize efficacy while limiting adverse effects and resistance. In oncology and rheumatology, intermittent high-dose regimens or pulsed corticosteroid therapy are used for specific indications. In analgesia and neurology, pulse dosing schedules have been employed to balance efficacy with side effects.

Advantages of pulsdosis include the potential for higher peak drug exposure with lower overall continuous exposure, reduced tolerance for certain agents, and flexibility in timing. Limitations include the need for careful regimen design to avoid subtherapeutic levels, potential fluctuations in symptom control, and logistical challenges for delivery systems, especially with drugs that have long half-lives or significant accumulation.

The term pulsdosis appears in different medical literatures to describe this general approach, though the specifics and popularity of pulse dosing vary by drug class, condition, and clinical context. Ongoing research examines how pulsed regimens compare with continuous dosing for efficacy, safety, and resistance profiles.