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Inmedicine andpharmacology, atrough level ortrough concentration (Ctrough) is theconcentration reached by adrug immediately before the next dose is administered,[1][2] often used intherapeutic drug monitoring. The name comes from the idea that on a graph of concentration versus time, the line forms a U-shaped trough at the lowest region, before a newdose sends it higher again. The usual criterion is concentration in theblood serum, although in some instances local concentration withintissues is relevant. It ispharmacokinetically normal that over time, the drugmolecules are beingmetabolized orcleared by the body, so the concentration of drug that remains available is dropping. In a medicine that is administered periodically, the trough level should be measured just before the administration of the next dose in order to avoid overdosing.[3] A trough level is contrasted with a "peak level" (Cmax), which is the highest level of the medicine in the body, and the "average level", which is the mean level over time. It is widely used in clinical trials for newer medicines to investigate therapeutic effectiveness and safety.
Ctrough is slightly different fromCmin, the minimum concentration during the time interval between administration of two doses.[1][2]
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