Analysis of oral anticancer drug interactions in clinical practice

• Autores: María José Aguilella Vizcaíno, Ignacio García Escobar, José Miguel Ferrari Piquero, María Pilar Gómez Serranillos Cuadrado
• Localización: European journal of clinical pharmacy: atención farmacéutica, ISSN 2385-409X, Vol. 16, Nº. 4, 2014, págs. 238-249
• Idioma: inglés
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• Resumen

  • Cancer patients are particularly susceptible to drug interactions (DI). Many of the oral anticancer drugs (OA) marketed in recent years present problems, such as adverse reactions and DI, since they are characterized by a narrow therapeutic margin. The objective of this study is to analyse and evaluate the potential DI of OA among cancer patients in a tertiary hospital. A retrospective study was carried out between January 2008 and November 2011, reviewing all DI in the study population and selecting those involving OA Patient-and DI-related variables were collected using the Micromedex Drug-Reax screening tool. The data were processed with the SPSS statistical package. Of the 614 patients analyzed, 46.74% suffered some DI 18.57% of the patients developed some DI involving an OA-the drug most commonly involved being erlotinib (61.8%), followed by lapatinib (48.1%). No interactions were found in the case of temozolamide, topotecan or gefitinib. Most of the DI (93.5%) were pharmacokinetic, while 4.1% were pharmacodynamic interactions. A total of 79.03% of the DI were rated as severe. Most DI with OA are mediated by proton pump inhibitors and antacids. Drug interactions mediated by CYP3A4 inhibitors/inducers, drugs capable of prolonging the QT-interval, anticoagulants and antacids were of particular relevance. Knowledge of the DI with OA in cancer patients is essential in order to allow adequate prevention and management, and thus to improve patient quality of life