Interactions with anticancer agents in clinical practice: more frequent than we imagine
(2010)
Files
pdfdocument.pdf
Restricted Access - Adobe PDF
- 1.06 MB
Details
- Authors
- Abstract
- Background and objective Drug interactions are an under-recognized and not much studied issue in oncology. However cancer patients often take many drugs besides their chemotherapy, and even a slight increase or decrease in cytotoxic activity due to a drug interaction could result in excessive toxicity or reduced efficacy. The purpose of this study was to evaluate the frequency of major and moderate interactions that involve anticancer agents in a group of cancer patients. Design A 10-week observational study. Setting Patients with solid malignancies who came to Mont-Godinne Hospital (Yvoir, Belgium) to receive chemotherapy or who were hospitalized in oncology during the study period were included. A clinical pharmacist questioned these patients about their ongoing treatments (including over-the-counter (OTC) drugs, herbs, and vitamins) and their alcohol and tobacco consumption. Three renowned drug interaction compendia were used to identify drug interactions: Micromedex Healthcare Series online, Epocrates online, and Stockley’s Drug Interactions 2008. Main outcome measures Frequency of interactions, type of drugs involved, consequences and management. Results One hundred and twenty-two patients (59 women, 63 men; mean age, 63) were included. Patients took an average of 7.5 (range, 1–22) medications including herbs and vitamins. More than 80% of patients used at least one OTC drug and 36% used herbs or vitamins. A total of 41 interactions of major or moderate severity involving an anticancer agent were identified among 25% of patients. Potential adverse consequences were far more often an increased toxicity than a decreased efficacy of one or both interacting drugs. The anticancer drugs mostly involved were cisplatin and methotrexate, and the most frequent co-medications involved were vitamin K antagonists, proton pump inhibitors and diuretics. Conclusions Interactions involving anticancer agents are frequent. Unfortunately little is known about the prevalence of adverse drug events due to these interactions. Despite this, it is essential that preventive measures are taken to avoid increased toxicity or decreased efficacy of the drugs, at least for more frequent and more severe interactions. Most of the time, this simply involves surveillance of biological or clinical parameters. In this case, collaboration with a clinical pharmacist may be useful for the prescribing physician.
- Affiliations
Citations
Mouzon, A., Kerger, J., Gillet, P., Hecq, J.-D., & Spinewine, A. (2010). Interactions with anticancer agents in clinical practice: more frequent than we imagine. Pharmacy World and Science : international journal of clinical pharmacy and pharmaceutical care, 32(2), 232. https://doi.org/10.1007/s11096-010-9378-9 (Original work published 2010)