Gender differences in pharmacokinetics predict side effects in women

Zucker, I., Prendergast, BJ Gender differences in pharmacokinetics predict side effects in women. BIOL Gender Differences 11, 32 (2020). https://doi.org/10.1186/s13293-020-00308-5

Commentary

This study was designed to determine whether gender differences in pharmacokinetics and PK predict gender differences in ADRs in men and women. The reason behind this study was done because some of the doses of medication administered are based on males, and since clinical trials and other studies are based on males, there have been many reports of adverse effects in females that are considered overdose.

The results of this study showed that for most of the FDA-approved drugs tested, elevated blood levels and prolonged elimination times were strongly associated with women. Of the 86 drugs evaluated, 76 had higher PK values in women, and for 59 drugs with clinically identifiable ADRs, sex-biased PK predicted the direction of sex-biased ADRs in 88% of cases.

Ninety-six percent of drugs with female-biased PK values were associated with a higher incidence of ADRs in females than in males, but only 29% of male-biased PK predicted male-biased ADRs.

With this result,

gender differences in pharmacokinetics strongly predict gender-specific ADRs in females but not males. However, it could not be explained by sex differences in body weight. This suggests that the common practice of prescribing equal medication doses to women and men ignores pharmacokinetic sex differences and weight dimorphism, puts women at risk for overmedication, and contributes to female-biased adverse effects.