Sex differences in metabolism and pharmacokinetics

Abstract

Men and women may differ in their therapeutic and/or adverse responses to certain drugs. These differences can be due to sex- or sex hormone-related effects on the drug disposition process, particularly those involving drug-metabolizing enzymes and transporters. This chapter will review sex-associated differences in drug pharmacokinetics in general, but also focus on the special circumstances of pregnancy, menopause, and the use of hormonal contraceptives, highlighting evidence demonstrating these differences for anti-infectives. Better characterization of the impact of sex on drug dispositions would guide therapeutic choices and dosing schedule for men and women and enhance treatment outcomes for many commonly prescribed anti-infectives.