Risco de toxicidade medicamentosa em pacientes com metástase hepática de câncer colorretal: implicações para ajustes de doses

Abstract

Objective: To analyze the risk of drug toxicity in patients with hepatic dysfunction secondary to liver metastasis from colorectal cancer, focusing on pharmacokinetic foundations and implications for dose adjustment. Methodology: This is an integrative literature review with a qualitative approach, conducted through searches in the Scientific Electronic Library Online (SciELO), PubMed, and Google Scholar databases, using descriptors in Portuguese and English related to the topic, including studies published between 2015 and 2025. Results: Hepatic dysfunction was shown to significantly alter the metabolism of several drugs, such as irinotecan, fluoropyrimidines, and opioids, increasing systemic exposure and the risk of adverse effects. In addition, limited standardization in clinical guidelines regarding dose adjustment for these patients was observed. Final considerations: This integrative review made it possible to identify that hepatic dysfunction secondary to colorectal cancer metastasis is directly associated with an increased risk of drug toxicity, due to changes in pharmacokinetic processes, especially hepatic metabolism. It’ s concluded that individualized pharmacotherapy, based on clinical and laboratory assessment, is essential to reduce risks, highlighting the role of the pharmacist in promoting pharmacotherapeutic safety and methods.