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Sex-Related Differences in Pharmacokinetics and Pharmacodynamics of Frequently Prescribed Drugs: A Review of the Literature

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Abstract

While there is considerable evidence about sex-related differences between men and women in drug metabolism, efficacy and safety of frequently prescribed drugs such as analgesics, tranquillizers, statins and beta-blockers, clinicians’ awareness of the implications on dosing and adverse event monitoring in routine practice is inadequate. Some drugs are more effective in men than women (e.g. ibuprofen) or vice versa (e.g. opioids, benzodiazepine), typically owing to pharmacodynamic causes. The 5-hydroxytryptamine (5-HT) receptor 3 antagonist alosetron is approved for women only since it largely lacks efficacy in men. For statins, equal efficacy was demonstrated in secondary prevention of cardiovascular events, but primary prevention is still under debate. For some drugs (e.g. paracetamol, metoprolol), women are at significantly higher risk of adverse effects. Therefore, considering sex-specific features in clinical trials and therapeutic guidelines is warranted to ensure efficacy and safety of medicines.

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Acknowledgements

Funding

No funding was received for the preparation of this review of the literature. The Rapid Service fee was funded by the corresponding author.

Medical Writing and Editorial Assistance

The authors wish to acknowledge the contribution of Margit Hemetsberger, Hemetsberger Medical Services, Vienna, Austria, for editorial assistance, funded by the corresponding author.

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All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Disclosures

André Farkouh, Thomas Riedl, Roman Gottardi, Martin Czejka and Alexandra Kautzky-Willer declare no conflicts of interest in this work. The authors do not have any commercial or proprietary interest in the products discussed or their respective companies.

Compliance with Ethics Guidelines

This article is based on previously conducted studies and does not contain any studies with human participants or animals performed by any of the authors.

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Data sharing is not applicable to this article as no datasets were generated or analysed during the current literature review.

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Authors and Affiliations

  1. Department of Pharmaceutical Chemistry, Division of Clinical Pharmacy and Diagnostics, Faculty of Life Sciences, University of Vienna, Vienna, Austria

    André Farkouh & Martin Czejka

  2. Apotheke Zum Engel, Public Pharmacy, Krems-Stein, Austria

    Thomas Riedl

  3. Department of Cardiovascular Surgery, Landeskrankenhaus Salzburg, Paracelsus Medical University, Salzburg, Austria

    Roman Gottardi

  4. Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria

    Alexandra Kautzky-Willer

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Farkouh, A., Riedl, T., Gottardi, R. et al. Sex-Related Differences in Pharmacokinetics and Pharmacodynamics of Frequently Prescribed Drugs: A Review of the Literature. Adv Ther 37, 644–655 (2020). https://doi.org/10.1007/s12325-019-01201-3

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