The Clinical Potential for Therapeutic Drug Monitoring in Alternative Matrices: Considerations for Systemic and Compartmentalized Pharmacology.

Therapeutic drug monitoring (TDM) using alternative matrices beyond traditional venous blood-based approaches, such as capillary blood-based microsampling, cerebrospinal fluid, breast milk, and peripheral blood mononuclear cells, has the potential to enhance precision medicine. Microsampling techniques provide a less invasive and cost-effective alternative for implementing TDM in populations from remote and access-limited areas. Evaluation of drug distribution across physiologic compartments based on pharmacokinetic principles can improve drug efficacy and minimize adverse effects in diverse clinical settings. It is essential to recognize that each matrix presents its own unique advantages and challenges that must be considered to determine its suitability for TDM.