Geriatric rheumatology: safe use of potentially toxic antirheumatics.

Despite what is known about pharmacokinetics in the elderly, there is little information regarding the relationship between age and disease-modifying antirheumatic agents or immunosuppressive drugs. Musculoskeletal diseases are common in the aging population, and the therapeutic use of potentially toxic pharmacologic agents, including immunosuppressives, is prevalent. A number of factors influence the potential for toxicity in this age group, including polypharmacy and age-related physiologic change. An overview of clinical pharmacologic factors in the elderly is presented, and available information on efficacy and toxicity of disease-modifying antirheumatics and immunosuppressives is reviewed.