Medications in Space: In Search of a Pharmacologist’s Guide to the Galaxy
Abstract
Medications have been used during space missions for more than half a century, yet our understanding of the effects of spaceflight on drug pharmacokinetics and pharmacodynamics is poor. The space environment induces time-dependent alterations in human physiology that include fluid shifts, cardiovascular deconditioning, bone and muscle density loss, and impaired immunity. This review presents the current knowledge on the physiological effects of spaceflight that can translate into altered drug disposition and activity and eventually to inadequate treatment. It describes findings from studies in astronauts along with mechanistic studies in animal models and in vitro systems. Future missions into deeper space and the emergence of commercial spaceflight will require a more detailed understanding of space pharmacology to optimize treatment in astronauts and space travelers.
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Cardiac arrhythmia is a problem that has been reported in long-duration spaceflight, especially related to a QT prolongation observed on electrocardiograms.
“Cardiac arrhythmia is a problem that has been reported in long-duration spaceflight, especially related to a QT prolongation observed on electrocardiograms110,114.”
When an astronaut is in orbit, a fluid shift from the intracellular to the extracellular compartment occurs due to increased permeability of capillary membranes.
“When an astronaut is in orbit, a fluid shift from the intracellular to the extracellular compartment occurs due to increased permeability of capillary membranes110,111.”
After a few days, diuresis reduces the extracellular fluid and plasma volume.
“However, after a few days, diuresis reduces the extracellular fluid and plasma volume110.”
Variation in blood and plasma flow can affect the rate of drug absorption, distribution, and elimination.
“This variation in blood and plasma flow can affect the rate of drug absorption, distribution, and elimination110,113.”
Spaceflight may be associated with hypersensitive reactions to some medications.
“Although this mechanism is not well understood, spaceflight may be associated with hypersensitive reactions to some medications110,117.”
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References 106 · Cited by 58
- Authors
- Eyal, S., & Derendorf, H.
- Affiliations
- Hebrew University of Jerusalem (IL)
- University of Florida (US)
- Corresponding author
- Eyal, Sara
- Venue
- Pharmaceutical Research
- Published
- 2019-08-14
- Volume
- 36
- Issue
- 10
- Pages
- 148-148
- ISSN
- 0724-8741 (ISSN-L)
- 1573-904X
- OpenAlex
- W2967486522
- Cited by
- 58
- References
- 106
- Citations by year
- 2026: 3 · 2025: 8 · 2024: 12 · 2023: 4 · 2022: 12 · 2021: 8 · 2020: 9 · 2019: 2
- FWCI
- 0.91
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Pharmaceutical Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- University of Washington
- Hebrew University of Jerusalem
- Topics
- Health Sciences › Medicine › Physiology › Spaceflight effects on biology
- Physical Sciences › Physics and Astronomy › Astronomy and Astrophysics › Space exploration and regulation
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacogenetics and Drug Metabolism
- Keywords
- spaceflight, pharmacokinetics, pharmacodynamics, drug disposition, astronauts, fluid shifts, cardiovascular deconditioning, impaired immunity, spaceflight physiology, commercial spaceflight
- MeSH terms
- Aerospace Medicine, Animals, Pharmaceutical Preparations, Gravitation, Humans, Pharmacokinetics, Space Flight, Weightlessness, Astronauts
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