Antidepressant Drug Interactions

2001 ◽  
Vol 14 (6) ◽  
pp. 467-477 ◽  
Author(s):  
Sheila R. Botts ◽  
Cara Alfaro
Keyword(s):  
Cytochrome P450 ◽  
Drug Interaction ◽  
Side Effects ◽  
Drug Interactions ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Antidepressant Drug ◽  
Pharmacodynamic Interactions ◽  
Toxicological Profile ◽  
Pharmacokinetic Drug ◽  
Isozyme System

Second-generation antidepressants are more selective in their pharmacological mechanisms and offer fewer side effects and a safer toxicological profile than cyclic antidepressants and monoamine oxidase inhibitors. While the risk for pharmacodynamic interactions is more limited than with older agents with broader receptor effects, the risks for pharmacokinetic interactions is greater. The capacity of selective serotonin reuptake inhibitors to inhibit the metabolic activity of cytochrome P450 isozyme system has spurred over a decade of intense psychopharmacological and pharmacogenetics research to better the understanding of the significance of these interactions. Clinicians have had to increase their knowledge and understanding of drug interaction potential to better manage patients receiving these newer antidepressants. The following is a review of both pharmacodynamic and pharmacokinetic drug-drug interactions with antidepressants.

Pharmacokinetic Drug-drug Interaction of Antibiotics Used in Sepsis Care in China

2020 ◽  
Vol 21 ◽  
Author(s):  
Xuan Yu ◽  
Zixuan Chu ◽  
Jian Li ◽  
Rongrong He ◽  
Yaya Wang ◽  
...  
Keyword(s):  
Drug Interaction ◽  
Drug Interactions ◽  
Penicillin G ◽  
Literature Mining ◽  
Human Pharmacokinetics ◽  
P450 Enzyme ◽  
Drug Drug Interaction ◽  
Pharmacokinetic Drug ◽  
Sepsis Care

Background: Many antibiotics have a high potential for having an interaction with drugs, as perpetrator and/or victim, in critically ill patients, and particularly in sepsis patients. Methods: The aim of this review is to summarize the pharmacokinetic drug-drug interaction (DDI) of 45 antibiotics commonly used in sepsis care in China. Literature mining was conducted to obtain human pharmacokinetics/dispositions of the antibiotics, their interactions with drug metabolizing enzymes or transporters, and their associated clinical drug interactions. Potential DDI is indicated by a DDI index > 0.1 for inhibition or a treated-cell/untreated-cell ratio of enzyme activity being > 2 for induction. Results: The literature-mined information on human pharmacokinetics of the identified antibiotics and their potential drug interactions is summarized. Conclusion: Antibiotic-perpetrated drug interactions, involving P450 enzyme inhibition, have been reported for four lipophilic antibacterials (ciprofloxacin, erythromycin, trimethoprim, and trimethoprim-sulfamethoxazole) and three lipophilic antifungals (fluconazole, itraconazole, and voriconazole). In addition, seven hydrophilic antibacterials (ceftriaxone, cefamandole, piperacillin, penicillin G, amikacin, metronidazole, and linezolid) inhibit drug transporters in vitro. Despite no reported clinical PK drug interactions with the transporters, caution is advised in the use of these antibacterials. Eight hydrophilic antibacterials (all β-lactams; meropenem, cefotaxime, cefazolin, piperacillin, ticarcillin, penicillin G, ampicillin, and flucloxacillin), are potential victims of drug interactions due to transporter inhibition. Rifampin is reported to perpetrate drug interactions by inducing CYP3A or inhibiting OATP1B; it is also reported to be a victim of drug interactions, due to the dual inhibition of CYP3A4 and OATP1B by indinavir. In addition, three antifungals (caspofungin, itraconazole, and voriconazole) are reported to be victims of drug interactions because of P450 enzyme induction. Reports for other antibiotics acting as victims in drug interactions are scarce.

Herbal Drug Interactions

2017 ◽  
pp. 201-231 ◽  
Author(s):  
Mymoona Akhter
Keyword(s):  
Drug Interaction ◽  
Side Effects ◽  
Adverse Effects ◽  
Drug Interactions ◽  
Herbal Medicines ◽  
Herbal Drugs ◽  
Herbal Drug ◽  
Herbal Therapy ◽  
Alternative Medicines ◽  
Regulatory Bodies

Use of complementary and alternative medicines (CAM) for preventive and therapeutic purposes has increased tremendously in the last two decades internationally. The manufacturers of these products are not required to submit proof of safety or efficacy to the Food and Drug Administration. As a result, the adverse effects and drug interactions associated with them are largely unknown. In this chapter, the author presents interactions of herbal medicines with other medicines (herbal or non-herbal). A large number of herbal drugs, including from single drug to a variety of mixtures have been used to treat kidney disorders. Herb-herb or herb drug interaction has been reported intensively during last decade, therefore it becomes important to keep an eye on the use of combination herbal therapy in order to avoid serious results because of interactions with each other. Due to the growing awareness about the interactions and side effects of herbal drugs/supplements over the past few years, regulatory bodies are working on these issues and pharmacopoeias are being developed for reference.

Drug–drug interactions

ESC CardioMed ◽  
2018 ◽  
pp. 226-233
Author(s):  
Jeffrey K. Aronson
Keyword(s):  
Drug Interaction ◽  
Protein Binding ◽  
Drug Interactions ◽  
Adverse Reactions ◽  
Mechanisms Of Action ◽  
Intravenous Drug ◽  
Cellular Distribution ◽  
Drug Infusion ◽  
Pharmacodynamic Interactions ◽  
Site Of Action

A drug interaction occurs when the effects of a drug are altered by the effects of another drug, a vaccine, herb, foodstuff, or device. In drug–drug interactions, a precipitant drug increases or reduces the effects of an object drug by pharmaceutical, pharmacokinetic, or pharmacodynamic mechanisms. Pharmaceutical interactions occur during intravenous drug infusion; they are avoidable by infusing drugs separately. Pharmacokinetic interactions can arise from altered absorption, protein binding, cellular distribution, metabolism, or excretion of an object drug. The last two mechanisms are the most important. Pharmacodynamic interactions can be direct (antagonism or synergism at the same site of action, or summation or synergism of similar effects at different sites) or indirect (when an outcome of an action of a precipitant drug alters the effects of an object drug). Some drug–drug interactions are beneficial, through combining drugs with different beneficial mechanisms of action or using drugs to reverse or prevent adverse reactions.

scholarly journals Drug-drug interactions in an era of multiple anticoagulants: a focus on clinically relevant drug interactions

Hematology ◽  
2018 ◽  
Vol 2018 (1) ◽  
pp. 339-347 ◽  
Author(s):  
Sara R. Vazquez
Keyword(s):  
Drug Interaction ◽  
Adverse Events ◽  
Drug Interactions ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Management Strategies ◽  
Antiplatelet Agents ◽  
Anticoagulant Drug ◽  
Interaction Management

Abstract Oral anticoagulants are commonly prescribed but high risk to cause adverse events. Skilled drug interaction management is essential to ensure safe and effective use of these therapies. Clinically relevant interactions with warfarin include drugs that modify cytochrome 2C9, 3A4, or both. Drugs that modify p-glycoprotein may interact with all direct oral anticoagulants, and modifiers of cytochrome 3A4 may interact with rivaroxaban and apixaban. Antiplatelet agents, nonsteroidal anti-inflammatory drugs, and serotonergic agents, such as selective serotonin reuptake inhibitors, can increase risk of bleeding when combined with any oral anticoagulant, and concomitant use should be routinely assessed. New data on anticoagulant drug interactions are available almost daily, and therefore, it is vital that clinicians regularly search interaction databases and the literature for updated management strategies. Skilled drug interaction management will improve outcomes and prevent adverse events in patients taking oral anticoagulants.

Drug interactions in palliative care

2010 ◽  
Author(s):  
Max Watson ◽  
Caroline Lucas ◽  
Andrew Hoy ◽  
Jo Wells
Keyword(s):  
Palliative Care ◽  
Cytochrome P450 ◽  
Side Effects ◽  
Drug Interactions ◽  
Dose Frequency ◽  
Drug Interventions

This chapter covers drug interventions in palliative care, including Cytochrome P450 isoenzymes. The chapter contains a large formulary of drugs including route, dose, frequency, and indications/ side-effects/ remarks.

2020 FDA Drug-drug Interaction Guidance: A Comparison Analysis and Action Plan by Pharmaceutical Industrial Scientists

2020 ◽  
Vol 21 (6) ◽  
pp. 403-426 ◽  
Author(s):  
Sirimas Sudsakorn ◽  
Praveen Bahadduri ◽  
Jennifer Fretland ◽  
Chuang Lu
Keyword(s):  
Cytochrome P450 ◽  
Drug Interaction ◽  
Drug Interactions ◽  
Action Plan ◽  
European Medicines Agency ◽  
Cytochrome P450 Enzyme ◽  
Interaction Studies ◽  
P450 Enzyme ◽  
Us Fda

Background: In January 2020, the US FDA published two final guidelines, one entitled “In vitro Drug Interaction Studies - Cytochrome P450 Enzyme- and Transporter-Mediated Drug Interactions Guidance for Industry” and the other entitled “Clinical Drug Interaction Studies - Cytochrome P450 Enzyme- and Transporter-Mediated Drug Interactions Guidance for Industry”. These were updated from the 2017 draft in vitro and clinical DDI guidance. Methods: This study is aimed to provide an analysis of the updates along with a comparison of the DDI guidelines published by the European Medicines Agency (EMA) and Japanese Pharmaceuticals and Medical Devices Agency (PMDA) along with the current literature. Results: The updates were provided in the final FDA DDI guidelines and explained the rationale of those changes based on the understanding from research and literature. Furthermore, a comparison among the FDA, EMA, and PMDA DDI guidelines are presented in Tables 1, 2 and 3. Conclusion: The new 2020 clinical DDI guidance from the FDA now has even higher harmonization with the guidance (or guidelines) from the EMA and PMDA. A comparison of DDI guidance from the FDA 2017, 2020, EMA, and PMDA on CYP and transporter based DDI, mathematical models, PBPK, and clinical evaluation of DDI is presented in this review.

Herbal Drug Interactions

2022 ◽  
pp. 120-141
Author(s):  
Mymoona Akhter
Keyword(s):  
Drug Interaction ◽  
Side Effects ◽  
Adverse Effects ◽  
Drug Interactions ◽  
Herbal Medicines ◽  
Herbal Drugs ◽  
Herbal Drug ◽  
Herbal Therapy ◽  
Alternative Medicines ◽  
Regulatory Bodies

Use of complementary and alternative medicines (CAM) for preventive and therapeutic purposes has increased tremendously in the last two decades internationally. The manufacturers of these products are not required to submit proof of safety or efficacy to the Food and Drug Administration. As a result, the adverse effects and drug interactions associated with them are largely unknown. In this chapter, the author presents interactions of herbal medicines with other medicines (herbal or non-herbal). A large number of herbal drugs, including from single drug to a variety of mixtures have been used to treat kidney disorders. Herb-herb or herb drug interaction has been reported intensively during last decade, therefore it becomes important to keep an eye on the use of combination herbal therapy in order to avoid serious results because of interactions with each other. Due to the growing awareness about the interactions and side effects of herbal drugs/supplements over the past few years, regulatory bodies are working on these issues and pharmacopoeias are being developed for reference.

A Brief Review of a New Antibiotic: Meropenem-vaborbactam

2019 ◽  
Vol 34 (3) ◽  
pp. 187-191
Author(s):  
Benjamin Gibson
Keyword(s):  
Cytochrome P450 ◽  
Urinary Tract ◽  
Side Effects ◽  
Drug Interactions ◽  
Urinary Tract Infections ◽  
Dose Adjustment ◽  
Bacterial Resistance ◽  
Blood Levels ◽  
Cytochrome P450 Enzymes ◽  
Tract Infections

Meropenem-vaborbactam is a newly approved antibiotic for complex urinary tract infections and to treat carbapenem-resistant Enterobacteriaceae infections. Its advantage over meropenem is the betalactamase inhibitor which slows bacterial resistance. This medication has been studied in numerous countries and has relatively few side effects. There were slightly higher incidences of alanine aminotransferase (ALT), aspartate aminotransferase (AST), elevations, infusion site phlebitis, but less anemia, vaginal infections, and discontinuation when compared with pipercacilin-tazobactam.<br/> The combination drug's relevance for the geriatrician is that older adults are at higher risk for urinary tract infections (UTIs). Some drugs that had previously been prescribed are now less useful for treating UTIs. This leaves clinicians with drugs that have more side effects.<br/> This new drug has two significant drug interactions. Meropenem competes with probenecid in the kidney's tubular secretion. This increases the concentration of meropenem. Meropenem lessens valproic acid blood levels, putting patients at risk for seizures. It is not known to impact cytochrome p450 enzymes. It comes as a dry powder and should be diluted in 250 mL of normal saline and given over a three-hour infusion.<br/> Vaborbactam is not known to have drug interactions. Vaborbactam does not affect the cytochrome p450 enzymes. This antibiotic has been studied in patients as old as 92 years. Renal dose adjustment allows the medication to be administered safely at all stages of kidney disease. If a patient is on dialysis, it is to be given after dialysis. No dose adjustment is needed based on the Child-Pugh score (i.e., for hepatic function). Based on local resistance, it may be beneficial to add this medication to one's formulary.

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