The Best And Worst Drugs For Women

[sbk]

A very informative and interesting article regarding OTC and prescription drugs and their effects on women here on MSN

Don't look now, but you have a drug problem.

Yes, you—and your mother, too. In fact, all women do. We're 50 to 70% more likely to suffer bad reactions to the drugs we take, studies show—and our side effects tend to be more serious. We're close to a third more likely than a man to quit taking the medicine we've been prescribed, at least for some diseases—even if stopping increases the risk of death. Just as bad, says Marianne Legato, MD, founder and director of the Foundation for Gender-Specific Medicine in New York City, some of the drugs we take simply may not help us get well. "Doctors need to pay attention to this," she says. "But too often, they don't."

How bad is the situation? Most drugs are equal-opportunity healers. But out of 10 prescription drugs pulled from the market between 1997 and 2001, 8 primarily harmed women. A couple of them, the popular allergy remedies Seldane and Hismanal, were found to cause changes in heart rhythm—a rare but potentially deadly side effect. The problem was discovered after a 39-year-old woman was hospitalized with fainting and light-headedness. She'd been taking Seldane along with an antibiotic and then added a common antifungal drug for a yeast infection—and was lucky to survive.

It's not just female hormones that put women at risk of dying of a runny nose. Nor is it simply that women tend to take more medicines than men do. Our whole physical makeup contributes to our problems with drugs. Women have a higher percentage of body fat than men, which affects how fast some drugs reach our organs. We're more apt to be "slow metabolizers": Our bodies can take longer to break down medicines, which therefore build up to potentially dangerous levels.

Our brains aren't the same, either. And last year, a study in mice found that genes in every organ act differently in males and females—thousands of genes in the liver alone, which could have a major impact on drug metabolism, reports lead researcher Aldons Lusis, PhD, a geneticist at UCLA. "Our study revealed huge differences," Lusis says, adding that there's every reason to think the same variability occurs in humans.

Legato sums it up: "Women are not just small men."

Aspirin, ibuprofen, acetaminophen: They all do the job and are safe when used according to directions. But it doesn't take much to overdose on acetaminophen, and doing so can wreck the liver. According to a 2005 study at the University of Washington, taking too much of the painkiller is the most common cause of sudden liver failure in the United States. And of those hospitalized with acetaminophen-related acute liver failure, 74% were women.

There are several reasons for women's increased vulnerability. They seem to take more acetaminophen than men do. They can also take the drug unwittingly, because acetaminophen is in more than 100 over-the-counter remedies for colds and flu, insomnia, allergies, and more. It's possible, as well, that women's bodies break down acetaminophen's toxic by-product more slowly, researchers say. If so, their livers would be exposed longer to higher concentrations of harmful substances.

Best for women: Don't take more than 4 g or eight extrastrength (500 mg) tablets of acetaminophen a day, and read labels carefully to make sure you're not unintentionally taking the drug in other remedies. (The FDA may soon require clearer labels, making acetaminophen harder to overlook.) Be extra careful if you're even a moderate social drinker, because alcohol slows the breakdown of the chemical that does the damage. And if you need long-term pain relief (for arthritis, for instance), consider switching to a different pain reliever—or say good-bye to the cocktails.

You need an antibiotic

Just like the abandoned allergy drug Seldane, plenty of medicines currently on the market can occasionally cause dangerous changes in a woman's heart rhythm. In fact, in a United Kingdom survey, 3% of all prescriptions were for nonheart drugs that carry this side effect. One of the most widely used: erythromycin. The danger goes up if you also take another drug that can affect your heart the same way.

A large study from Vanderbilt University in 2004 found that people were twice as likely to suffer sudden death from cardiac causes when they were on the antibiotic—and five times as likely to die if they were using an antifungal drug such as ketoconazole (sometimes used for yeast infections) at the same time. Fortunately, the danger of a serious problem was low, even with the increased risk. Still, two-thirds of drug-induced arrhythmias occur in women.

What causes a woman's extra sensitivity? Her heart's electrical system differs from a man's: It takes longer for her heart to relax after each beat. The risky drugs lengthen that interval even more, sometimes so much that the heart essentially stops pumping blood.

You're worried about heart disease

It took a long time for scientists and practicing physicians to get it through their heads that women are at risk of cardiovascular disease, says women's health researcher Anthony. "In the ER, women used to be sent home because their heart attack wasn't recognized," she says. "It even showed in the language that was used—men's symptoms were called 'typical,' and women had 'atypical' symptoms."

So maybe it shouldn't be surprising that experts have known since 1989 that a healthy man can cut his heart attack risk by 44%, simply by taking a low-dose aspirin every other day—but they didn't know what the same drug could do for a woman until 2005. The answer: If she didn't have heart disease, aspirin didn't lower her odds of having a heart attack at all.

Still, the 2005 findings showed an upside for aspirin, says study leader Julie Buring, ScD, a professor of medicine at Harvard Medical School. The 10-year study of nearly 40,000 women revealed that regularly taking a low-dose pill cuts the risk of stroke by 17%—a sizable advantage, because women are actually at a higher risk of stroke than heart attack.

Best for women: If you're under age 65, says Buring, you probably can forget about preventive aspirin and focus on diet and exercise to lower your chances of a heart attack. (Consider a statin, too, if you need it for high cholesterol.) But if you have stroke risks—you have a family history, you're African American, or you have high blood pressure or diabetes—talk with your doctor about whether adding low-dose aspirin makes sense for you.

There's more about depression, asthma, birth control pills (fact: its a myth that all antibiotics noticeably erode the pills effectiveness), surgery and pain control.

It sums up with the following:

4 risky habits—and the moves that could save your life

Men and women don't just differ in anatomy—they also behave differently. And some of the things women do make their medicines less effective or raise the risk of side effects. Plus, studies show that doctors may not take women's complaints as seriously as men's. You can't make those differences go away, but you can keep them from hurting you. Here are four problem behaviors and the stay-safe ways to change them.

Risk: Women take more drugs than men do—and that increases the risk of interactions.

Smart Move: Make a list of the remedies you take and bring it to your doctor. Include prescription, over-the-counter, and herbal preparations. You should also mention supplements, including vitamins and minerals, some of which can interfere with medications.

Risk: Women with certain diseases are more likely to stop taking their prescriptions—which can have life-threatening consequences.

Smart Move: Talk with your doctor before stopping a drug. One recent study looked at patients with heart failure, says Susan Bennett, MD, a cardiologist and spokesperson for the American Heart Association. "The study showed that if you don't adhere to your medication regimen, you're more likely to die," she says. "Yet women were almost a third more likely to have poor adherence." If a medicine has irritating side effects, don't just drop it. Tell your doctor; you may be able to reduce the dose or switch to a different drug.

Risk: Doctors discount women's reports of pain—sometimes leaving them in misery.

Smart Move: Calmly tell your doctor about your problem. Your pain may be less likely to be taken seriously if you get emotional while describing it, says Anita Tarzian, PhD, RN, an ethics and research consultant in the Law & Health Care Program of the University of Maryland Law School. "It's valid to get upset—and you should be able to talk about it. But the downside is that the doctor may think you're just anxious or depressed." What can help, she says: Make a list of your pain symptoms and their triggers and rate your discomfort on a 0-to-10 scale.

Risk: Women discount their own experience, too—and that can lead to more side effects or less benefit from drugs.

Smart Move: Describe your symptoms...as often as necessary. "Women have to realize that they may not experience a drug the same way men did in the clinical trials," says cardiologist Marianne Legato, MD. "If they find that small doses have a huge impact, that's not in their imagination. If they have unusual side effects, that also may be true. And if they're told by a doctor, 'We don't see that in studies'—well, the reason is that the studies were done in men. It's very important for women to report their symptoms accurately, and to hold firm."

Lots of interesting information as well as good advice here.

[Jet Gorgon]

Thanks, SBK. Informative. I believe women have a much higher tolerance to pain than do men.

Anyway, I rarely take drugs for pain. An aspirin once a year, maybe. Never do antibiotics for the fast cure either; saving them for if I get really ill. Hope all the TV women take a read of this article.

Txs.

[gisele]

When you go to the doctor's here, they just love giving you lots of little plastic packets of pills, for this that and the other thing.

[somchai jones]

'The best drug for women?'

A nice mellow joint before sex!

I apologize for my frivolity.