The significance of sex and gender in clinical pharmacokinetics

Abstract

The consequences of the historical exclusion of cisgender women, intersex, and transgender people from pharmacological clinical trials have resulted in a dangerously low quality of care for these populations. Analyzing and interpreting significant sex and gender-related differences in drug absorption, distribution, metabolism, and excretion are critical for adjusting dosing regimens and therapeutic drug monitoring. A deep understanding of the impact of these differences is required for practitioners and clinical researchers. This review summarizes the physiological differences between sexes as they relate to cardiovascular, respiratory, gastrointestinal, and renal variations. A direct examination of their possible effects on the pharmacokinetics of drugs critically highlights the current knowledge gap. The importance of including both sexes in all scientific research is emphasized in this review. It serves as a reminder for future scientists to strive toward reducing health care disparities based on sex and gender in their studies, and to incorporate sex and gender-specific analysis whenever possible.