TY - CHAP
T1 - Sex differences in drug effects
T2 - Interaction with sex hormones in adult life
AU - Spoletini, Ilaria
AU - Vitale, Cristiana
AU - Malorni, Walter
AU - Rosano, Giuseppe M C
PY - 2012
Y1 - 2012
N2 - In recent years, it has become clear that women and men may differ for drug response. Also, there is an increasing recognition on the role of sex hormones on pharmacokinetics and pharmacodynamics as mechanism accounting for sex differences in drug effects. In women, the phases of menstrual cycle, of reproductive life and fluctuations in the concentrations of sexual steroids on pharmacokinetics and pharmacodynamics must be considered. Furthermore, the use of oral contraceptives or hormonal replacement therapy, the sex hormone-related changes in total body water or in the amount of fat influence the overall effect of drugs. On the contrary, the influence of androgens on drug effects is minimal because of the even plasma levels of these hormones in adult males. Nevertheless, since women have been scarcely included in the early phases of clinical trials, the results obtained in men have been often translated to women and their exact response to drugs is still not well known. The available evidence suggests that sex hormones influence drug absorption, distribution, metabolism, pharmacodynamics, and adverse effects. For instance, many cardiovascular drugs are metabolized by enzymes of the cytochrome P450 mono-oxygenases system, which is more expressed in females than in males, showing sex differences in drug response. Upcoming pharmacological research should aim to further clarify the influence of sex hormones on drug effects and, for this purpose, to increase the number of women enrolled in all phases of clinical trials. An evidence-based pharmacotherapy in women is therefore auspicable for women's health.
AB - In recent years, it has become clear that women and men may differ for drug response. Also, there is an increasing recognition on the role of sex hormones on pharmacokinetics and pharmacodynamics as mechanism accounting for sex differences in drug effects. In women, the phases of menstrual cycle, of reproductive life and fluctuations in the concentrations of sexual steroids on pharmacokinetics and pharmacodynamics must be considered. Furthermore, the use of oral contraceptives or hormonal replacement therapy, the sex hormone-related changes in total body water or in the amount of fat influence the overall effect of drugs. On the contrary, the influence of androgens on drug effects is minimal because of the even plasma levels of these hormones in adult males. Nevertheless, since women have been scarcely included in the early phases of clinical trials, the results obtained in men have been often translated to women and their exact response to drugs is still not well known. The available evidence suggests that sex hormones influence drug absorption, distribution, metabolism, pharmacodynamics, and adverse effects. For instance, many cardiovascular drugs are metabolized by enzymes of the cytochrome P450 mono-oxygenases system, which is more expressed in females than in males, showing sex differences in drug response. Upcoming pharmacological research should aim to further clarify the influence of sex hormones on drug effects and, for this purpose, to increase the number of women enrolled in all phases of clinical trials. An evidence-based pharmacotherapy in women is therefore auspicable for women's health.
KW - Drug adverse effects
KW - Estrogen
KW - Pharmacodynamics
KW - Pharmacokinetics
KW - Progesterone
KW - Sex
KW - Testosterone
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U2 - 10.1007/978-3-642-30726-3_5
DO - 10.1007/978-3-642-30726-3_5
M3 - Chapter
C2 - 23027447
AN - SCOPUS:84868334415
SN - 9783642307256
VL - 214
T3 - Handbook of Experimental Pharmacology
SP - 91
EP - 105
BT - Handbook of Experimental Pharmacology
ER -