Table 2.

Medications with published dose recommendations in obesity.

Drug	Recommended dose adjustment
Antibiotics and antimycotics109
Aminoglycosides	Ideal body weighta + 0.4 (total body weight – ideal body weight), drug monitoring
Vancomycin	Total body weight, drug monitoring
Beta-lactam antibiotics	Few data, adjustment most likely according to body surface area
Daptomycin	Total body weight, a little less if appropriate
Flucytosine	Ideal body weight
Amphothericine	LBM (few data)
Tuberculostatics	Ideal body weight (few data)
Anesthetics82,110
Thiopental	Induction of anesthesia: LBM
	Maintenance of anesthesia: total body weight
Propofol	Induction of anesthesia: LBM
	Maintenance of anesthesia: total body weight
Fentanyl	LBM
Remifentanil	LBM
Succinylcholine	Total body weight
Vecuronium	Ideal body weight
Rocuronium	Ideal body weight
Atracurium	Ideal body weight
Cisatracurium	Ideal body weight
Benzodiazepines	Loading dose: total body weight
	Maintenance dose: ideal body weight
Antithrombotics111,112
Low molecular weight heparins	Prophylaxis: fixed-dose increased according to total body weight (few data)
	Treatment: total body weight, maximal dose in extreme obesity if necessary
Fondaparinux	Prophylaxe: fixed-dose maybe increased (few data)
	Treatment: body weight >100 kg: 10 mg daily

^aIdeal body weight is the weight for which, based on a specific body height, the longest life expectancy was determined. There are a number of formulas that can be used to calculate ideal body weight, the formulas provide equivalent results.¹¹³

LBM, lean body mass (~ fat free mass).