What is dose titration?
It is adjusting the dose of a medication based on recommended dose range and frequency until the desired therapeutic effect is achieved. For example, the usual dose range of acetaminophen (Tylenol®) for managing mild to moderate pain in the elderly is 325 to 650mg given 3 to 4 times daily or 1000mg given every 4 to 6 hours. • Start with an initial dose of 325mg given every 8 hours. • If the resident needs another dose sooner than every 8 hours after 4 to 6 doses, increase the frequency to every 6 hours or the dose to 650mg every 8 hours. • If the resident continues to need a larger dose, continue increasing the dose or frequency until the maximum daily dose of 2000mg or 3000mg is reached (depending on the resident’s kidney and liver functions). • Once the recommended maximum dose of acetaminophen for elderly patients is reached, consider switching to a low-dose NSAID such as ibuprofen 200mg every 4 to 6 hours or choline magnesium trisalicylate or salasalate.
