Title:Potential Drug-Drug Interactions Between Anti-Cancer Drugs and Other
Medications in Lung Cancer Patients: A Retrospective Study
Volume: 18
Issue: 2
Author(s): Rosella Ayesha Pinto, Mahadev Rao*, Arpita Roy, Levin Thomas, Karthik S. Udupa and Vasudeva Guddattu
Affiliation:
- Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, MAHE, Manipal, India
Keywords:
Lung cancer, drug-drug interactions, pharmacokinetics, pharmacodynamics, anti-cancer drugs, anti-tumour agents.
Abstract:
Background: Cancer patients are more vulnerable to developing drug-drug interactions
as multiple medications are administered concomitantly with cytotoxic agents to treat the
underlying comorbidities. These drug-drug interactions often receive less medical attention and
consequently are associated with adverse clinical outcomes.
Objective: We intended to comprehensively characterize the drug-drug interactions among
anticancer drugs and other concomitantly prescribed drugs in hospitalized lung cancer patients.
Methods: A retrospective, observational, single-centre study was conducted on lung cancer
inpatients from the medical records department of Kasturba Hospital, Manipal, India. Drug-drug
interactions were identified using the drug interaction checkers of two drug information databases,
Micromedex and Epocrates. These drug-drug interactions were categorized based on the source
from which they were identified, mechanism, severity/significance, adverse consequences, and
management strategies required.
Results: Among 196 patients, 555 drug-drug interactions were identified in 185 patients using
Micromedex and Epocrates. Based on the mechanism of action, 74% and 22% of the drug-drug interactions
were classified as pharmacodynamic and pharmacokinetic respectively. 112 drug-drug
interactions were recorded from Micromedex alone, while 549 interactions were found using
Epocrates. The oral chemotherapeutic drug gefitinib was found to be associated with the highest
number of drug-drug interactions.
Conclusion: Drug-drug interactions were highly prevalent among hospitalized lung cancer
patients. Structured screening and monitoring for these potentially clinically relevant drug-drug
interactions by oncologists in collaboration with clinical pharmacists should be carried out prior to
initiation and during anticancer treatment to prevent adverse clinical outcomes.