Therapeutic drug monitoring · MIPD
The right dose, for the right patient, at the right time.
Plug'n'Dose distributes, integrates and supports Tucuxi, decision support software developed by CHUV and HEIG-VD. Using population pharmacokinetic models and Bayesian inference, Tucuxi helps personalise dose adjustment.
- Developed since 2012 by CHUV and HEIG-VD
- Open source
- Already in use in several university hospitals
- Predicted median
- 25th to 75th percentiles
- 5th to 95th percentiles
- Trough target
- Dose
- Measurement
- Without adjustment
- Measured concentration
- 17.0mg/L Sampled at 35.5 h, before the 4th dose
- Estimated clearance
- 3.2L/h 90% interval: 2.7 to 3.8 L/h
- Steady-state trough
- 18.1mg/L Above target Current dosage, target 8 to 15 mg/L
- Suggested dosage
- 750mg every 12 h Predicted trough: 13.6 mg/L, from the 5th dose
Illustration with a fictitious drug and a simplified model. Try the real Tucuxi calculation engine
Plug'n'Dose
Making therapeutic drug monitoring simpler and more accessible
A French company founded in 2025, we make Tucuxi installable, connected to your systems and used day to day.
- Pharmacy and clinical departments
Healthcare institutions
Personalised regimens, connected to the patient record.
Let's talk about your project - Laboratory medicine
Laboratories
Every drug level comes with an interpretation and a recommendation.
Let's talk about your project - Analysers and automated systems
Diagnostics manufacturers
Decision support added to the results of your analysers.
Let's talk about your project
A clinical, technical and operational alliance
Julien Massari
Founder and President
Pharmacokinetics engineer.
Prof. Thierry Buclin
Scientific and clinical lead
Pharmacologist, professor emeritus at CHUV, initiator of Tucuxi.
Prof. Yann Thoma
Technical lead
Professor at HEIG-VD, lead developer of Tucuxi.
How it works
From a measurement to a personalised dosage
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Data
Automatic retrieval
The assay result and the patient context (identity, dosage, dosing times, weight, age, creatinine) are retrieved from the health record or the laboratory system. No manual re-entry, fewer identification errors.
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Model
Population model
Each drug is described by a drug model file: a published population pharmacokinetic model, its covariates, its therapeutic targets and the available doses.
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Computation
Bayesian inference
The computation engine confronts the model with the patient's measurement. The broad population distribution narrows into an individual a posteriori estimate, with its uncertainty.
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Recommendation
Personalised dosage
Tucuxi assesses the current dosage against the target, suggests an adjustment and predicts its effect. The interpretation report is ready to send; the decision remains with the prescriber.
Demonstrator
The Tucuxi engine, in your browser
A fictitious patient, five public drug models and the actual Tucuxi computation engine. Change a value: the prediction and the suggested dosages are recalculated.
The demonstrator requires JavaScript and WebAssembly. For a guided demonstration, contact us.
Local computation by tucuxi-core (HEIG-VD and CHUV, AGPL v3 licence, sources), drug models from the public tucuxi-drugs repository. Nothing is sent to a server. This demonstrator is not CE marked and must never be used to determine a patient's dosage.
Why a model
Each patient has their own pharmacokinetics. And their own dosage.
Therapeutic drug monitoring (TDM) measures a drug's concentration to adjust each patient's dose.
Empirical TDM
A measurement, a rule
- Assumes steady state
- Requires precise sampling times
- Adjusts the dose by simple proportion
MIPD
A measurement, within a model
- Uses every measurement, even before steady state
- Accounts for the patient: weight, age, renal function
- Predicts the effect of the adjustment
Tucuxi
Open software, from public research
Developed at CHUV and HEIG-VD, published as open source, with its drug models publicly available.
Already in use in several university hospitals
- CHUV
- AP-HP
- AP-HM
- HCL
Open-source version, at the institutions' own initiative.
An evaluated and published technology
Piperacillin: target attainment by dosing strategy
Estimated probability of reaching the target trough (8 to 32 mg/L), 80 treatment courses analysed with Tucuxi
Recent publications
- 2025Individualization of piperacillin dosage based on therapeutic drug monitoring with or without model-informed precision dosing: a scenario analysisHaefliger D. et al. J Antimicrob Chemother
- 2024Bayesian vancomycin model selection for therapeutic drug monitoring in neonatesAlrahahleh D. et al. Clin Pharmacokinet
- 2024Pharmacokinetic consideration of venetoclax in acute myeloid leukemia patients: a potential candidate for TDM?Philippe M. et al. Ther Drug Monit
- 2023AUC-based monitoring and model-informed precision dosing of vancomycin in critically ill patients: why and how?Goutelle S. et al. Anaesth Crit Care Pain Med
- 2022Implementation and comparison of two pharmacometric tools for model-based therapeutic drug monitoring and precision dosing of daptomycinHeitzmann J. et al. Pharmaceutics
Application areas
- Anti-infectivesCefepime, daptomycin, darunavir, dolutegravir, doravirine, gentamicin, lopinavir, meropenem, piperacillin, rifampicin, teicoplanin, tobramycin, vancomycin.
- Oncology and haematologyBusulfan, imatinib, ponatinib, venetoclax.
- TransplantationTacrolimus.
- CardiologyApixaban.
- Inflammatory diseasesBiologics, anti-TNF.Drug model to create for the project
- Neurology and psychiatryAntiepileptics, lithium, psychotropics.Drug model to create for the project
- Intensive care
- Paediatrics and neonatology
- Renal or hepatic impairment
- Obesity
- Renal replacement therapy
- Extracorporeal circulation
View the references of the published models
- Apixaban
- Cirincione
- Busulfan
- Ben Hassine (adults), Ben Hassine (paediatrics), Paci
- Cefepime
- Buclin
- Daptomycin
- Dvorchik
- Darunavir
- Daskapan
- Dolutegravir
- Barcelo
- Doravirine
- Yee
- Gentamicin
- Fuchs
- Imatinib
- Gotta
- Lopinavir
- Fuchs
- Meropenem
- Li
- Piperacillin
- Chen, Li
- Ponatinib
- Hanley
- Rifampicin
- Svensson
- Tacrolimus
- Andrews, Cai, Monchaud, Nanga, Sikma, Storset, Han
- Teicoplanin
- Ogami
- Tobramycin
- Hennig
- Vancomycin
- Colin, Dao, De Cock, Frymoyer, Goti, Grimsley, Liu, Llopis-Salvia, Staatz, Thomson, Yamamoto, Kimura, Lee, Lo, Mehrotra, Mulubwa
- Venetoclax
- Brackman
Catalogue checked on 30 September 2026 against the official list of Tucuxi models. Several models may apply to different populations. The demonstrator above loads five drug models; this catalogue lists all the models published on the official website.
Tucuxi technical sheet
- Licence
- Open source, AGPL v3
- Origin
- Clinical pharmacology at CHUV and HEIG-VD, since 2012
- Computation
- Bayesian inference: population, a priori and a posteriori predictions, percentiles
- Targets
- Trough, peak, AUC, cumulative AUC, AUC/MIC, time above MIC
- Routes
- Intravenous bolus, infusion, extravascular route
- Connectivity
- Reading from and writing to a remote database (LIS, EHR), import of requests in XML
- Output
- Interpretation report for the prescriber
Regulatory status: open-source version without CE marking, medical device marking planned. Learn more
Accompagnement
A project, in three stages
We take care of what separates open software from a tool used every day in your departments.
- 01
Scope
Drugs, patients and data flows concerned.
- Model selection
- Regulatory process
- 02
Connect and configure
Connection to your systems, drug models.
- Distribution
- LIS and EHR integration
- 03
Train and support
Hands-on training, then long-term follow-up.
- Training
- Maintenance
Questions
Frequently asked questions
Another question about Tucuxi or a deployment project? Write to us.
Is a concentration measurement needed to use Tucuxi?
No. Without a measurement, Tucuxi provides an a priori prediction based on the population model and the patient's characteristics. Each measured concentration then refines the a posteriori prediction, including outside steady state.
Does Tucuxi replace the pharmacologist's expertise?
No. Tucuxi is a decision support tool: it computes, positions the measurement and suggests a reasoned adjustment. The decision remains with the prescriber, informed by the opinion of the pharmacologist, pharmacist or laboratory biologist.
Which drugs are available?
The Tucuxi catalogue lists 19 drugs and 43 models (see application areas and models). Five drug models are loaded in the demonstrator. Any drug with a published model can be given a new drug model, created with the online editor; we support model selection and the creation of the drug model.
What is the regulatory status of Tucuxi?
The open-source version of Tucuxi is not a CE-marked medical device: it is used under the responsibility of the institutions that install it. CE marking as medical device software is a Plug'n'Dose project.
Is Tucuxi open-source software?
Yes. It is released as open source under the AGPL v3 licence and its drug models are in a public repository. Plug'n'Dose provides installation, integration with information systems, training and the regulatory process.
Contact
Let's talk about your project
Healthcare institutions, clinical laboratories, diagnostics manufacturers: write to us to explore how Tucuxi could be set up in your context.
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