Do standard doses of frequently prescribed drugs cause preventable adverse effects in women?

Adverse effects from prescription medications are a leading cause of disability and death in the United States, and more than 75% of these adverse effects are dose related. This analysis examines women's experience with dose-related adverse effects of several major medication groups, induding oral contraceptives, hormone replacement therapy, anti-inflammatory drugs, antihypertensives, statins, and others. The original recommended doses for oral contraceptives and conjugated estrogens were 100% to 800% higher than the doses recommended today. Unnecessarily high doses of ibuprofen and terfenadine were linked to serious and lethal dose-related adverse effects, and proven effective lower doses of celecoxib, fluoxetine, omeprazole, and many other medications were not initially marketed or recommended. Much of the data on effective low doses of drugs is not readily available to physicians or patients. The lack of information on or recommendations for the lowest, proven-effective doses of many major medications may in part explain the continued high incidence of dose-related adverse effects. The findings in this article suggest that women, especially elderly women, may be prone to adverse effects linked to unnecessarily high drug doses.