ARE THERE SEX DIFFERENCES IN DRUG EFFECTS?
A major genetic difference present in all populations is the one responsible for dividing individuals into the two sexes. Men and women express different drug metabolism enzymes at different levels; that is, many cytochrome P450s are differentially expressed in the liver or kidneys of men and women. In addition, men and women have different body masses. Therefore, it is not surprising that men and women often react differently to drugs. Antihypertensive, antipsychotic, and antidepressant drugs all have been shown to have different effects in men and women (Table 1). Surprisingly, however, sex differences have only recently been considered in research studies investigating clinical efficacy.
Table 1. Examples of Different Responses of Men and Women to Drugs
|Statins||Females have greater tendency for myopathy|
|Verapamil||Females have greater blood pressure decrease|
|Amlodipine||Females have greater blood pressure decrease|
|Aspirin||Females have greater risk reduction for stroke but less for myocardial infarction|