What is the best course of action if the steady-state drug level is too high?

When the steady-state drug level is too high, the best course of action is to decrease the dose. The steady-state concentration of a drug is reached when the rate of drug administration equals the rate of elimination. If the level is too high, it likely indicates that the dose being administered is greater than what the body can eliminate efficiently, which could lead to toxicity or adverse effects.

Decreasing the dose directly reduces the amount of drug in the body, helping to bring the plasma concentration back within the therapeutic range. This adjustment is often necessary when monitoring drug levels for medications with narrow therapeutic indices, where the distinction between effective and toxic dosing is slim. By reducing the dose, the balance between efficacy and safety can be maintained.

Choosing to decrease the dose interval would potentially increase the concentration even further, as drug administration would occur more frequently. Similarly, decreasing the dose and the dose interval together could still lead to elevated drug levels if not carefully managed. Changing the route of administration may also complicate the pharmacokinetics and not effectively address the issue of the high steady-state level directly related to the current dosage. Thus, reducing the dose is the most straightforward and effective means to rectify a situation where the drug levels are too high.