Introduction: Chronotherapy is an emerging concept in the field of pharmacy.It involves altering the time of drug administration to improve effectiveness and minimize treatment side-effects. This review scopes current literature for evidence supporting the basis of drug chronotherapy.
Method: A literature search was conducted in three databases (Medline, Embaseand International Pharmaceutical Abstracts) using the search terms “Chronotherapy”, “Chronopharmacology”, ‘‘Chronopharmacokinetics’’, ‘‘Chronopharmacodynamics”, “Chronoefficacy”, “Chronoformulation “, “Morning and/or/vs. Evening”, “Morning and/or/vs. Bedtime” and their combinations. The selection criteria for the inclusion of articles in the review included years (years 2008 – August 2011), publication in English language, studies done in Humans and non –review articles that pertained to drug therapy only.
Results: Our search revealed a total of 192 journal articles, of which 41articles were selected for review. The specific hypothesis for the effectiveness of chronotherapy that was tested in these 41 studies was chronoeffectiveness (n=34), followed by chronopharmacokinetics (n=5), chronomodulation (n=3) and chronopharmacodynamics (n=2). The most common study design utilized in these studies was the Randomised Control Trial (RCT) (n=34). The most studied disease condition was hypertension (n=19) followed by ocular hypertension or glaucoma, respiratory disease, rheumatoid arthritis and, type-2 diabetes and hypertension (n=3).
Conclusion: The study presents the scope of chronotherapy in drug utilization. The knowledge of chronotherapy is growing and the current research for chronotherapy is promisingly in the conceptualization or early experimental phase. Going forward, chronotherapy studies should also explore genetic, gender and age related differences. Preliminary screening of new drugs for chronotherapeutic potential may be a way of enhancing quality use of medicines.