Skip to main content
Erschienen in: Cancer Chemotherapy and Pharmacology 6/2013

01.06.2013 | Original Article

Potential drug–drug interactions at a referral hematology–oncology ward in Iran: a cross-sectional study

verfasst von: Molouk Hadjibabaie, Shirinsadat Badri, Sarah Ataei, Amir Hossein Moslehi, Iman Karimzadeh, Ardeshir Ghavamzadeh

Erschienen in: Cancer Chemotherapy and Pharmacology | Ausgabe 6/2013

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To assess the pattern and probable risk factors for moderate and major drug–drug interactions in a referral hematology–oncology ward in Iran.

Methods

All patients admitted to hematology–oncology ward of Dr. Shariati Hospital during a 6-month period and received at least two anti-cancer or non-anti-cancer medications simultaneously were included. All being scheduled anti-cancer and non-anti-cancer medications both prescribed and administered during ward stay were considered for drug–drug interaction screening by Lexi-Interact On-Desktop software.

Results

One hundred and eighty-five drug–drug interactions with moderate or major severity were detected from 83 patients. Most of drug–drug interactions (69.73 %) were classified as pharmacokinetics. Fluconazole (25.95 %) was the most commonly offending medication in drug–drug interactions. Interaction of sulfamethoxazole-trimethoprim with fluconazole was the most common drug–drug interaction (27.27 %). Vincristine with imatinib was the only identified interaction between two anti-cancer agents. The number of administered medications during ward stay was considered as an independent risk factor for developing a drug–drug interaction.

Conclusions

Potential moderate or major drug–drug interactions occur frequently in patients with hematological malignancies or related diseases. Performing larger standard studies are required to assess the real clinical and economical effects of drug–drug interactions on patients with hematological and non-hematological malignancies.
Literatur
1.
Zurück zum Zitat Fuhr U (2008) Improvement in the handling of drug–drug interactions. Eur J Clin Pharmacol 64:167–171PubMedCrossRef Fuhr U (2008) Improvement in the handling of drug–drug interactions. Eur J Clin Pharmacol 64:167–171PubMedCrossRef
2.
3.
Zurück zum Zitat Lu C, Liao M, Cohen L, Xia CQ (2010) Emerging in vitro tools to evaluate cytochrome P450 and transporter-mediated drug–drug interactions. Curr Drug Discov Technol 7:199–222PubMed Lu C, Liao M, Cohen L, Xia CQ (2010) Emerging in vitro tools to evaluate cytochrome P450 and transporter-mediated drug–drug interactions. Curr Drug Discov Technol 7:199–222PubMed
4.
Zurück zum Zitat Köhler GI, Bode-Böger SM, Busse R, Hoopmann M, Welte T, Böger RH (2000) Drug-drug interactions in medical patients: effects of in-hospital treatment and relation to multiple drug use. Int J Clin Pharmacol Ther 38:504–513PubMed Köhler GI, Bode-Böger SM, Busse R, Hoopmann M, Welte T, Böger RH (2000) Drug-drug interactions in medical patients: effects of in-hospital treatment and relation to multiple drug use. Int J Clin Pharmacol Ther 38:504–513PubMed
5.
6.
Zurück zum Zitat Egger SS, Drewe J, Schlienger RG (2003) Potential drug–drug interactions in the medication of medical patients at hospital discharge. Eur J Clin Pharmacol 58:773–778PubMed Egger SS, Drewe J, Schlienger RG (2003) Potential drug–drug interactions in the medication of medical patients at hospital discharge. Eur J Clin Pharmacol 58:773–778PubMed
7.
Zurück zum Zitat Glintborg B, Andersen SE, Dalhoff K (2005) Drug-drug interactions among recently hospitalised patients–frequent but mostly clinically insignificant. Eur J Clin Pharmacol 61:675–681PubMedCrossRef Glintborg B, Andersen SE, Dalhoff K (2005) Drug-drug interactions among recently hospitalised patients–frequent but mostly clinically insignificant. Eur J Clin Pharmacol 61:675–681PubMedCrossRef
8.
Zurück zum Zitat Herr RD, Caravati EM, Tyler LS, Iorg E, Linscott MS (1992) Prospective evaluation of adverse drug interactions in the emergency department. Ann Emerg Med 21:1331–1336PubMedCrossRef Herr RD, Caravati EM, Tyler LS, Iorg E, Linscott MS (1992) Prospective evaluation of adverse drug interactions in the emergency department. Ann Emerg Med 21:1331–1336PubMedCrossRef
9.
Zurück zum Zitat Goldberg RM, Mabee J, Chan L, Wong S (1996) Drug-drug and drug-disease interactions in the ED: analysis of a high-risk population. Am J Emerg Med 14:447–450PubMedCrossRef Goldberg RM, Mabee J, Chan L, Wong S (1996) Drug-drug and drug-disease interactions in the ED: analysis of a high-risk population. Am J Emerg Med 14:447–450PubMedCrossRef
10.
Zurück zum Zitat Guédon-Moreau L, Ducrocq D, Duc MF, Quieureux Y, L’Hôte C, Deligne J, Caron J (2004) Absolute contraindications in relation to potential drug interactions in outpatient prescriptions: analysis of the first five million prescriptions in 1999. Eur J Clin Pharmacol 59:899–904PubMedCrossRef Guédon-Moreau L, Ducrocq D, Duc MF, Quieureux Y, L’Hôte C, Deligne J, Caron J (2004) Absolute contraindications in relation to potential drug interactions in outpatient prescriptions: analysis of the first five million prescriptions in 1999. Eur J Clin Pharmacol 59:899–904PubMedCrossRef
11.
Zurück zum Zitat Buajordet I, Ebbesen J, Erikssen J, Brørs O, Hilberg T (2001) Fatal adverse drug events: the paradox of drug treatment. J Intern Med 250:327–341PubMedCrossRef Buajordet I, Ebbesen J, Erikssen J, Brørs O, Hilberg T (2001) Fatal adverse drug events: the paradox of drug treatment. J Intern Med 250:327–341PubMedCrossRef
12.
Zurück zum Zitat Riechelmann RP, Del Giglio A (2009) Drug interactions in oncology: how common are they? Ann Oncol 20:1907–1912PubMedCrossRef Riechelmann RP, Del Giglio A (2009) Drug interactions in oncology: how common are they? Ann Oncol 20:1907–1912PubMedCrossRef
14.
Zurück zum Zitat Barrons R (2004) Evaluation of personal digital assistant software for drug interactions. Am J Health Syst Pharm 61:380–385PubMed Barrons R (2004) Evaluation of personal digital assistant software for drug interactions. Am J Health Syst Pharm 61:380–385PubMed
15.
Zurück zum Zitat Vonbach P, Dubied A, Krähenbühl S, Beer JH (2008) Evaluation of frequently used drug interaction screening programs. Pharm World Sci 30:367–374PubMedCrossRef Vonbach P, Dubied A, Krähenbühl S, Beer JH (2008) Evaluation of frequently used drug interaction screening programs. Pharm World Sci 30:367–374PubMedCrossRef
16.
Zurück zum Zitat Reis AM, Cassiani SH (2010) Evaluation of three brands of drug interaction software for use in intensive care units. Pharm World Sci 32:822–828PubMedCrossRef Reis AM, Cassiani SH (2010) Evaluation of three brands of drug interaction software for use in intensive care units. Pharm World Sci 32:822–828PubMedCrossRef
18.
Zurück zum Zitat Riechelmann RP, Tannock IF, Wang L, Saad ED, Taback NA, Krzyzanowska MK (2007) Potential drug interactions and duplicate prescriptions among cancer patients. J Natl Cancer Inst 99:592–600PubMedCrossRef Riechelmann RP, Tannock IF, Wang L, Saad ED, Taback NA, Krzyzanowska MK (2007) Potential drug interactions and duplicate prescriptions among cancer patients. J Natl Cancer Inst 99:592–600PubMedCrossRef
19.
Zurück zum Zitat Kannan G, Anitha R, Rani VN, Thennarasu P, Alosh J, Vasantha J, Martin JR, Uma MR (2011) A study of drug–drug interactions in cancer patients of a south Indian tertiary care teaching hospital. J Postgrad Med 57:206–210PubMedCrossRef Kannan G, Anitha R, Rani VN, Thennarasu P, Alosh J, Vasantha J, Martin JR, Uma MR (2011) A study of drug–drug interactions in cancer patients of a south Indian tertiary care teaching hospital. J Postgrad Med 57:206–210PubMedCrossRef
20.
Zurück zum Zitat Guastaldi RB, Reis AM, Figueras A, Secoli SR (2011) Prevalence of potential drug–drug interactions in bone marrow transplant patients. Int J Clin Pharm 33:1002–1009PubMedCrossRef Guastaldi RB, Reis AM, Figueras A, Secoli SR (2011) Prevalence of potential drug–drug interactions in bone marrow transplant patients. Int J Clin Pharm 33:1002–1009PubMedCrossRef
21.
Zurück zum Zitat Riechelmann RP, Moreira F, Smaletz O, Saad ED (2005) Potential for drug interactions in hospitalized cancer patients. Cancer Chemother Pharmacol 56:286–290PubMedCrossRef Riechelmann RP, Moreira F, Smaletz O, Saad ED (2005) Potential for drug interactions in hospitalized cancer patients. Cancer Chemother Pharmacol 56:286–290PubMedCrossRef
22.
Zurück zum Zitat Strandell J, Wahlin S (2011) Pharmacodynamic and pharmacokinetic drug interactions reported to VigiBase, the WHO global individual case safety report database. Eur J Clin Pharmacol 67:633–641PubMedCrossRef Strandell J, Wahlin S (2011) Pharmacodynamic and pharmacokinetic drug interactions reported to VigiBase, the WHO global individual case safety report database. Eur J Clin Pharmacol 67:633–641PubMedCrossRef
23.
Zurück zum Zitat McCoy D, Depestel DD, Carver PL (2009) Primary antifungal prophylaxis in adult hematopoietic stem cell transplant recipients: current therapeutic concepts. Pharmacotherapy 29:1306–1325PubMedCrossRef McCoy D, Depestel DD, Carver PL (2009) Primary antifungal prophylaxis in adult hematopoietic stem cell transplant recipients: current therapeutic concepts. Pharmacotherapy 29:1306–1325PubMedCrossRef
24.
Zurück zum Zitat Nivoix Y, Ubeaud-Sequier G, Engel P, Levêque D, Herbrecht R (2009) Drug-drug interactions of triazole antifungal agents in multimorbid patients and implications for patient care. Curr Drug Metab 10:395–409PubMedCrossRef Nivoix Y, Ubeaud-Sequier G, Engel P, Levêque D, Herbrecht R (2009) Drug-drug interactions of triazole antifungal agents in multimorbid patients and implications for patient care. Curr Drug Metab 10:395–409PubMedCrossRef
25.
Zurück zum Zitat Cronin S, Chandrasekar PH (2010) Safety of triazole antifungal drugs in patients with cancer. J Antimicrob Chemother 65:410–416PubMedCrossRef Cronin S, Chandrasekar PH (2010) Safety of triazole antifungal drugs in patients with cancer. J Antimicrob Chemother 65:410–416PubMedCrossRef
26.
Zurück zum Zitat Leather HL (2004) Drug interactions in the hematopoietic stem cell transplant (HSCT) recipient: what every transplanter needs to know. Bone Marrow Transplant 33:137–152PubMedCrossRef Leather HL (2004) Drug interactions in the hematopoietic stem cell transplant (HSCT) recipient: what every transplanter needs to know. Bone Marrow Transplant 33:137–152PubMedCrossRef
27.
Zurück zum Zitat Schmidt H, Naumann R, Jaschonek K, Einsele H, Dopfer R, Ehninger G (1989) Drug interaction between cyclosporin and phenytoin in allogeneic bone marrow transplantation. Bone Marrow Transplant 4:212–213PubMed Schmidt H, Naumann R, Jaschonek K, Einsele H, Dopfer R, Ehninger G (1989) Drug interaction between cyclosporin and phenytoin in allogeneic bone marrow transplantation. Bone Marrow Transplant 4:212–213PubMed
28.
Zurück zum Zitat Keown PA, Laupacis A, Carruthers G, Stawecki M, Koegler J, McKenzie FN, Wall W, Stiller CR (1984) Interaction between phenytoin and cyclosporine following organ transplantation. Transplantation 38:304–306PubMed Keown PA, Laupacis A, Carruthers G, Stawecki M, Koegler J, McKenzie FN, Wall W, Stiller CR (1984) Interaction between phenytoin and cyclosporine following organ transplantation. Transplantation 38:304–306PubMed
29.
Zurück zum Zitat Freeman DJ, Laupacis A, Keown PA, Stiller CR, Carruthers SG (1984) Evaluation of cyclosporin-phenytoin interaction with observations on cyclosporin metabolites. Br J Clin Pharmacol 18:887–893PubMedCrossRef Freeman DJ, Laupacis A, Keown PA, Stiller CR, Carruthers SG (1984) Evaluation of cyclosporin-phenytoin interaction with observations on cyclosporin metabolites. Br J Clin Pharmacol 18:887–893PubMedCrossRef
30.
Zurück zum Zitat Mori T, Aisa Y, Kato J, Nakamura Y, Ikeda Y, Okamoto S (2009) Drug interaction between voriconazole and calcineurin inhibitors in allogeneic hematopoietic stem cell transplant recipients. Bone Marrow Transplant 44:371–374PubMedCrossRef Mori T, Aisa Y, Kato J, Nakamura Y, Ikeda Y, Okamoto S (2009) Drug interaction between voriconazole and calcineurin inhibitors in allogeneic hematopoietic stem cell transplant recipients. Bone Marrow Transplant 44:371–374PubMedCrossRef
31.
Zurück zum Zitat van der Ven AJ, Schoondermark-van de Ven EM, Camps W, Melchers WJ, Koopmans PP, van der Meer JW, Galama JM (1996) Anti-toxoplasma effect of pyrimethamine, trimethoprim and sulphonamides alone and in combination: implications for therapy. J Antimicrob Chemother 38:75–80PubMedCrossRef van der Ven AJ, Schoondermark-van de Ven EM, Camps W, Melchers WJ, Koopmans PP, van der Meer JW, Galama JM (1996) Anti-toxoplasma effect of pyrimethamine, trimethoprim and sulphonamides alone and in combination: implications for therapy. J Antimicrob Chemother 38:75–80PubMedCrossRef
32.
Zurück zum Zitat Gill HJ, Maggs JL, Madden S, Pirmohamed M, Park BK (1996) The effect of fluconazole and ketoconazole on the metabolism of sulphamethoxazole. Br J Clin Pharmacol 42:347–353PubMedCrossRef Gill HJ, Maggs JL, Madden S, Pirmohamed M, Park BK (1996) The effect of fluconazole and ketoconazole on the metabolism of sulphamethoxazole. Br J Clin Pharmacol 42:347–353PubMedCrossRef
33.
Zurück zum Zitat Winter HR, Trapnell CB, Slattery JT, Jacobson M, Greenspan DL, Hooton TM, Unadkat JD (2004) The effect of clarithromycin, fluconazole, and rifabutin on sulfamethoxazole hydroxylamine formation in individuals with human immunodeficiency virus infection (AACTG 283). Clin Pharmacol Ther 76:313–322PubMedCrossRef Winter HR, Trapnell CB, Slattery JT, Jacobson M, Greenspan DL, Hooton TM, Unadkat JD (2004) The effect of clarithromycin, fluconazole, and rifabutin on sulfamethoxazole hydroxylamine formation in individuals with human immunodeficiency virus infection (AACTG 283). Clin Pharmacol Ther 76:313–322PubMedCrossRef
34.
Zurück zum Zitat Au WY, Kwong YL (2008) Arsenic trioxide: safety issues and their management. Acta Pharmacol Sin 29:296–304PubMedCrossRef Au WY, Kwong YL (2008) Arsenic trioxide: safety issues and their management. Acta Pharmacol Sin 29:296–304PubMedCrossRef
35.
Zurück zum Zitat Bagnes C, Panchuk PN, Recondo G (2010) Antineoplastic chemotherapy induced QTc prolongation. Curr Drug Saf 5:93–96PubMedCrossRef Bagnes C, Panchuk PN, Recondo G (2010) Antineoplastic chemotherapy induced QTc prolongation. Curr Drug Saf 5:93–96PubMedCrossRef
36.
Zurück zum Zitat Lien YC, Lin SM, Nithipongvanitch R, Oberley TD, Noel T, Zhao Q, Daosukho C, St Clair DK (2006) Tumor necrosis factor receptor deficiency exacerbated Adriamycin-induced cardiomyocytes apoptosis: an insight into the Fas connection. Mol Cancer Ther 5:261–269PubMedCrossRef Lien YC, Lin SM, Nithipongvanitch R, Oberley TD, Noel T, Zhao Q, Daosukho C, St Clair DK (2006) Tumor necrosis factor receptor deficiency exacerbated Adriamycin-induced cardiomyocytes apoptosis: an insight into the Fas connection. Mol Cancer Ther 5:261–269PubMedCrossRef
37.
Zurück zum Zitat Hilmer SN, Cogger VC, Muller M, Le Couteur DG (2004) The hepatic pharmacokinetics of doxorubicin and liposomal doxorubicin. Drug Metab Dispos 32:794–799PubMedCrossRef Hilmer SN, Cogger VC, Muller M, Le Couteur DG (2004) The hepatic pharmacokinetics of doxorubicin and liposomal doxorubicin. Drug Metab Dispos 32:794–799PubMedCrossRef
38.
Zurück zum Zitat Barbui T, Rambaldi A, Parenzan L, Zucchelli M, Perico N, Remuzzi G (1992) Neurological symptoms and coma associated with doxorubicin administration during chronic cyclosporin therapy. Lancet 339:1421PubMedCrossRef Barbui T, Rambaldi A, Parenzan L, Zucchelli M, Perico N, Remuzzi G (1992) Neurological symptoms and coma associated with doxorubicin administration during chronic cyclosporin therapy. Lancet 339:1421PubMedCrossRef
39.
Zurück zum Zitat Rushing DA, Raber SR, Rodvold KA, Piscitelli SC, Plank GS, Tewksbury DA (1994) The effects of cyclosporine on the pharmacokinetics of doxorubicin in patients with small cell lung cancer. Cancer 74:834–841PubMedCrossRef Rushing DA, Raber SR, Rodvold KA, Piscitelli SC, Plank GS, Tewksbury DA (1994) The effects of cyclosporine on the pharmacokinetics of doxorubicin in patients with small cell lung cancer. Cancer 74:834–841PubMedCrossRef
40.
Zurück zum Zitat Erlichman C, Moore M, Thiessen JJ, Kerr IG, Walker S, Goodman P, Bjarnason G, DeAngelis C, Bunting P (1993) Phase I pharmacokinetic study of cyclosporin A combined with doxorubicin. Cancer Res 53:4837–4842PubMed Erlichman C, Moore M, Thiessen JJ, Kerr IG, Walker S, Goodman P, Bjarnason G, DeAngelis C, Bunting P (1993) Phase I pharmacokinetic study of cyclosporin A combined with doxorubicin. Cancer Res 53:4837–4842PubMed
41.
Zurück zum Zitat Sonneveld P, Suciu S, Weijermans P, Beksac M, Neuwirtova R, Solbu G, Lokhorst H, van der Lelie J, Dohner H, Gerhartz H, Segeren CM, Willemze R, Lowenberg B, European Organization for Research and Treatment of Cancer (EORTC), Leukaemia Cooperative Group (LCG), Dutch Haemato-Oncology Cooperative Study Group (HOVON) (2001) Cyclosporin A combined with vincristine, doxorubicin and dexamethasone (VAD) compared with VAD alone in patients with advanced refractory multiple myeloma: an EORTC-HOVON randomized phase III study (06914). Br J Haematol 115:895–902PubMedCrossRef Sonneveld P, Suciu S, Weijermans P, Beksac M, Neuwirtova R, Solbu G, Lokhorst H, van der Lelie J, Dohner H, Gerhartz H, Segeren CM, Willemze R, Lowenberg B, European Organization for Research and Treatment of Cancer (EORTC), Leukaemia Cooperative Group (LCG), Dutch Haemato-Oncology Cooperative Study Group (HOVON) (2001) Cyclosporin A combined with vincristine, doxorubicin and dexamethasone (VAD) compared with VAD alone in patients with advanced refractory multiple myeloma: an EORTC-HOVON randomized phase III study (06914). Br J Haematol 115:895–902PubMedCrossRef
42.
Zurück zum Zitat Bartlett NL, Lum BL, Fisher GA, Brophy NA, Ehsan MN, Halsey J, Sikic BI (1994) Phase I trial of doxorubicin with cyclosporine as a modulator of multidrug resistance. J Clin Oncol 12:835–842PubMed Bartlett NL, Lum BL, Fisher GA, Brophy NA, Ehsan MN, Halsey J, Sikic BI (1994) Phase I trial of doxorubicin with cyclosporine as a modulator of multidrug resistance. J Clin Oncol 12:835–842PubMed
43.
Zurück zum Zitat Riechelmann RP, Zimmermann C, Chin SN, Wang L, O’Carroll A, Zarinehbaf S, Krzyzanowska MK (2008) Potential drug interactions in cancer patients receiving supportive care exclusively. J Pain Symptom Manage 35:535–543PubMedCrossRef Riechelmann RP, Zimmermann C, Chin SN, Wang L, O’Carroll A, Zarinehbaf S, Krzyzanowska MK (2008) Potential drug interactions in cancer patients receiving supportive care exclusively. J Pain Symptom Manage 35:535–543PubMedCrossRef
44.
Zurück zum Zitat Secoli SR, Figueras A, Lebrão ML, de Lima FD, Santos JL (2010) Risk of potential drug–drug interactions among Brazilian elderly: a population-based, cross-sectional study. Drugs Aging 27:759–770PubMedCrossRef Secoli SR, Figueras A, Lebrão ML, de Lima FD, Santos JL (2010) Risk of potential drug–drug interactions among Brazilian elderly: a population-based, cross-sectional study. Drugs Aging 27:759–770PubMedCrossRef
45.
Zurück zum Zitat Miranda V, Fede A, Nobuo M, Ayres V, Giglio A, Miranda M, Riechelmann RP (2011) Adverse drug reactions and drug interactions as causes of hospital admission in oncology. J Pain Symptom Manage 42:342–353PubMedCrossRef Miranda V, Fede A, Nobuo M, Ayres V, Giglio A, Miranda M, Riechelmann RP (2011) Adverse drug reactions and drug interactions as causes of hospital admission in oncology. J Pain Symptom Manage 42:342–353PubMedCrossRef
Metadaten
Titel
Potential drug–drug interactions at a referral hematology–oncology ward in Iran: a cross-sectional study
verfasst von
Molouk Hadjibabaie
Shirinsadat Badri
Sarah Ataei
Amir Hossein Moslehi
Iman Karimzadeh
Ardeshir Ghavamzadeh
Publikationsdatum
01.06.2013
Verlag
Springer-Verlag
Erschienen in
Cancer Chemotherapy and Pharmacology / Ausgabe 6/2013
Print ISSN: 0344-5704
Elektronische ISSN: 1432-0843
DOI
https://doi.org/10.1007/s00280-013-2162-5

Weitere Artikel der Ausgabe 6/2013

Cancer Chemotherapy and Pharmacology 6/2013 Zur Ausgabe

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.