Effects of High Altitude Exposure on Physiology and Pharmacokinetics

Background: High-altitude environments are known to result in a broad range of physiological changes in human body, which may influence various pharmacological processes and pharmacokinetics. A series of physiological systems reacting to a high-altitude stressor and the effects of these physiological alterations on pharmacokinetics have been investigated for decades. Methods: In this review, we summarized the effects of high altitude on human physiological alterations (including those in the gastrointestinal system, cardiovascular system, pulmonary system, hematocrit, drug metabolism enzyme system, and renal excretory system), as well as subsequent changes of pharmacokinetics (such as absorption, distribution, metabolism, and excretion of drugs). Results: In summary, it isclear that high altitudes can lead to a broad range of physiological changes, leading to the changes in the ADME process of drugs. Conclusion: According to previous pharmacokinetics studies in human, the pharmacokinetics changes due to high altitude exposure may require dosage regimen modifications to maintain drug efficacy and safety, which should draw our attention to drug administration dosage for those planning ascent to high altitudes.