Down syndrome (DS; trisomy 21) is the most common survivable disorder due to 
aneuploidy. Individuals with DS may experience multiple comorbid health problems 
including congenital heart defects, endocrine abnormalities, skin and dental 
problems, seizure disorders, leukemia, dementia, and obesity. These associated 
conditions may necessitate pharmacotherapeutic management with various drugs. 
The complex pathobiology of DS may alter drug disposition and drug response in 
some individuals. For example, reports have documented increased rates of 
adverse drug reactions in patients with DS treated for leukemia and dementia. 
Intellectual disability resulting from DS may impact adherence to medication 
regimens. In this review, we highlight literature focused on pharmacotherapy for 
individuals with DS. We discuss reports of altered drug disposition or response 
in patients with DS and explore social factors that may impact medication 
adherence in the DS setting. Enhanced monitoring during drug therapy in 
individuals with DS is justified based on reports of altered drug disposition, 
drug response, and other characteristics present in this population.