The protective index is a comparison of the amount of a therapeutic agent that causes the therapeutic effect to the amount that causes toxicity. Quantitatively, it is the ratio given by the toxic dose divided by the therapeutic dose. A protective index is the toxic dose of a drug for 50% of the population (TD₅₀) divided by the minimum effective dose for 50% of the population (ED₅₀). A high protective index is preferable to a low one: this corresponds to a situation in which one would have to take a much higher dose of a drug to reach the toxic threshold than the dose taken to elicit the therapeutic effect. A drug should ordinarily only be administered if the protective index is greater than one, indicating that the benefit outweighs the risk.



The protective index is similar to the therapeutic index

Therapeutic index

The therapeutic index is a comparison of the amount of a therapeutic agent that causes the therapeutic effect to the amount that causes death or toxicity ....

, but concerns toxicity (TD₅₀) rather than lethality ; thus, the protective index is a smaller ratio. Toxicity can take many forms, as drugs typically have multiple side effects of varying severity, so a specific criterion of toxicity must be specified for the protective index to be meaningful. Ideally a choice is made such that the harm caused by the toxicity just outweighs the benefit of the drug's effect. Thus, the protective index is a more accurate measure of the benefit-to-risk ratio than the therapeutic index, but is less objectively defined. Nevertheless, the therapeutic index can be viewed as an upper bound

Upper bound

In mathematics, especially in order theory, an upper bound of a subset S of some partially ordered set is an element of P which is greater than or equal to every element of S. The term lower bound is defined dually as an element of P which is lesser than or equal to every element of S...

to the protective index for a given substance.