A drug as a two-faced Janus: dose-effect, adverse events

Introduction: In the pharmaceutical industry, the 21st century was marked by the creation of new highly effective drugs: synthetic, immunobiological, genetic engineering, etc. Pharmacotherapy with highly effective drugs leads to a detailed study of their safety and pharmacoepidemiological studies, both in our country and abroad. Materials and Methods: The work used content analysis, monitoring of scientific articles using the databases PubMed, Scopus, Google Scholar, ResearchGate, analysis of the nomenclature of the State Register of Medicines of the Russian Federation (2017-2024) and the Register of Medicines of Russia (2017-2024). Results and Discussion: Adverse drug reactions (ADRs). Adverse drug reactions (ADRs) are diverse in their clinical manifestations, mechanisms of action and frequency of occurrence. The main factors from the use of drugs that cause ADRs and influence on often irreversible complications. Safety of pharmacotherapy when using optically active drugs. Safety of pharmacotherapy when using antioxidants. Pharmacovigilance for monitoring and safety of medicinal products. Conclusion: Irrational pharmacotherapy with highly effective drugs (antioxidants, optically active drugs) without taking into account individual doses leads to errors both by medical personnel and to errors in self-medication especially for the treatment of central nervous system diseases. The problem of safety of pharmacotherapy is solved with the introduction of rational pharmacovigilance and safety monitoring programs.