Human space exploration challenges many of the assumptions on which modern pharmacotherapy is based. Spaceflight-induced physiological changes may influence drug pharmacokinetics and pharmacodynamics, while long-duration missions introduce additional constraints related to medication stability, safety, monitoring and individualized treatment. Yet, our understanding of how medicines behave in space remains limited.

This keynote will explore how these challenges are driving new approaches to clinical pharmacology, including microsampling, therapeutic drug monitoring and precision pharmacotherapy, illustrated by research conducted during parabolic flights and in space-analogue environments.

Beyond supporting astronaut health, space is also emerging as a unique environment for pharmaceutical innovation, opening new opportunities in disease modelling, drug discovery, AI-supported pharmacology and biomanufacturing. Emerging European and international collaborative networks are helping to connect expertise across pharmacology, pharmacy, space medicine, academia and industry to structure this rapidly evolving field.

Ultimately, preparing pharmacology for exploration beyond Earth may also help us rethink how medicines are developed, monitored and personalized on Earth.