Herxheimer A
Department of Clinical Pharmacology and Therapeutics, Charing Cross and Westminster Medical School, Charing Cross Hospital, London, UK.
Lancet. 1991 Feb 9;337(8737):346-8. doi: 10.1016/0140-6736(91)90958-r.
Many recommended drug doses are higher than necessary, for two reasons. Drugs are often introduced at a dose that will be effective in around 90% of the target population, because this helps market penetration. Doses are also partly determined by an irrational preference for round numbers. The dose excess due to such digit preference may be as much as 70% of the correct dose and on average is probably 25%. Needlessly high doses are bound to cause avoidable unwanted effects in a proportion of patients. Rigorous methods must be used to determine the doses recommended and the amount of drug to be put into a tablet or other dosage form.
许多推荐的药物剂量高于所需剂量，原因有两个。药物通常以对约90%的目标人群有效的剂量引入，因为这有助于市场推广。剂量还部分由对整数的不合理偏好决定。由于这种数字偏好导致的剂量过量可能高达正确剂量的70%，平均可能为25%。不必要的高剂量必然会在一定比例的患者中引起可避免的不良影响。必须采用严格的方法来确定推荐剂量以及片剂或其他剂型中药物的含量。
