Short Communication - (2025) Volume 14, Issue 2
Received: 03-Mar-2025, Manuscript No. jio-25-172178;
Editor assigned: 05-Mar-2025, Pre QC No. P-172178;
Reviewed: 19-Mar-2025, QC No. Q-172178;
Revised: 24-Mar-2025, Manuscript No. R-172178;
Published:
31-Mar-2025
, DOI: 10.37421/2329-6771.2025.14.553
Citation: Singh, Anika.” Drug-drug Interactions: A Pervasive Patient Risk.” J Integr Oncol 14 (2025):553.
Copyright: © 2025 Singh A. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution
and reproduction in any medium, provided the original author and source are credited.
New oral anticoagulants (NOACs) like direct oral anticoagulants (DOACs) are widely used, but they come with a significant risk of drug-drug interactions, particularly with other medications that affect their metabolism or elimination. Understanding these interactions is crucial for safe prescribing, as they can alter NOAC concentrations, leading to increased bleeding risk or reduced efficacy. Careful consideration of concomitant medications and patient characteristics is essential for minimizing adverse events[1].
The complex pharmacotherapy often required for COVID-19 patients, especially those with severe disease and comorbidities, makes them highly susceptible to clinically significant drug-drug interactions. Many antiviral, immunomodulatory, and supportive care drugs used in COVID-19 treatment can interact with each other or with chronic medications, necessitating vigilant monitoring and dose adjustments to prevent adverse outcomes and ensure therapeutic efficacy[2].
Herbal remedies, often perceived as natural and harmless, can significantly interact with conventional prescription drugs through both pharmacokinetic and pharmacodynamic mechanisms. These interactions can alter drug absorption, metabolism, distribution, and excretion, or interfere with their pharmacological targets. Healthcare providers need to be aware of common drug-herb interactions to advise patients and prevent potential adverse events[3].
Direct-acting antivirals (DAAs) have revolutionized Hepatitis C treatment, offering high cure rates. However, many DAAs are substrates or inhibitors/inducers of cytochrome P450 enzymes and transporters, leading to numerous pharmacokinetic drug-drug interactions. Managing these interactions is critical, especially in patients with comorbidities or those on other chronic medications, to avoid treatment failure or serious adverse effects[4].
Older adults are particularly vulnerable to drug-drug interactions due to polypharmacy, age-related physiological changes affecting pharmacokinetics and pharmacodynamics, and multiple comorbidities. These interactions can lead to increased adverse drug reactions, hospitalizations, and mortality. Effective prevention strategies involve medication review, deprescribing, and the use of clinical decision support systems[5].
Targeted cancer therapies, while effective, often involve complex drug regimens that can lead to significant drug-drug interactions. These interactions are particularly concerning in oncology patients who frequently take multiple medications for symptom management and comorbidities. Close monitoring and proactive management of potential interactions are crucial to optimize cancer treatment outcomes and minimize toxicity[6].
Drug-food interactions, though often overlooked, can substantially impact drug efficacy and safety by altering drug absorption, metabolism, or excretion. Specific foods or dietary components can modify drug pharmacokinetics or pharmacodynamics, potentially leading to therapeutic failure or increased toxicity. Educating patients about appropriate timing and dietary restrictions related to their medications is a key management strategy[7].
Pharmacogenomics holds promise for personalizing medicine by predicting individual responses to drugs, including susceptibility to adverse drug reactions and drug-drug interactions. Genetic variations in drug-metabolizing enzymes, transporters, and receptors can significantly alter drug exposure and effect. Integrating pharmacogenomic data into clinical practice could lead to more precise dosing and selection of medications, ultimately preventing harmful interactions[8].
Pre-exposure prophylaxis (PrEP) for HIV prevention involves potent antiretroviral drugs, which carry a risk of pharmacokinetic drug-drug interactions with other medications. These interactions can significantly alter PrEP drug levels, potentially compromising efficacy or increasing toxicity. A thorough understanding of these interactions is crucial for optimizing PrEP regimens and ensuring patient safety, particularly for individuals on concomitant medications[9].
Opioid analgesics are commonly prescribed but carry a significant risk of drug-drug interactions, primarily due to their metabolism by cytochrome P450 enzymes and central nervous system depressant effects. Concomitant use with other CNS depressants, enzyme inhibitors, or inducers can profoundly alter opioid concentrations and their pharmacological effects, leading to respiratory depression, sedation, or reduced analgesia. Clinicians must meticulously review medication lists to prevent these potentially fatal interactions[10].
New oral anticoagulants (NOACs) like direct oral anticoagulants (DOACs) are widely used, but they come with a significant risk of drug-drug interactions, particularly with other medications that affect their metabolism or elimination. Understanding these interactions is crucial for safe prescribing, as they can alter NOAC concentrations, leading to increased bleeding risk or reduced efficacy. Careful consideration of concomitant medications and patient characteristics is essential for minimizing adverse events[1].
The complex pharmacotherapy often required for COVID-19 patients, especially those with severe disease and comorbidities, makes them highly susceptible to clinically significant drug-drug interactions. Many antiviral, immunomodulatory, and supportive care drugs used in COVID-19 treatment can interact with each other or with chronic medications, necessitating vigilant monitoring and dose adjustments to prevent adverse outcomes and ensure therapeutic efficacy[2].
Herbal remedies, often perceived as natural and harmless, can significantly interact with conventional prescription drugs through both pharmacokinetic and pharmacodynamic mechanisms. These interactions can alter drug absorption, metabolism, distribution, and excretion, or interfere with their pharmacological targets. Healthcare providers need to be aware of common drug-herb interactions to advise patients and prevent potential adverse events[3].
Direct-acting antivirals (DAAs) have revolutionized Hepatitis C treatment, offering high cure rates. However, many DAAs are substrates or inhibitors/inducers of cytochrome P450 enzymes and transporters, leading to numerous pharmacokinetic drug-drug interactions. Managing these interactions is critical, especially in patients with comorbidities or those on other chronic medications, to avoid treatment failure or serious adverse effects[4].
Opioid analgesics are commonly prescribed but carry a significant risk of drug-drug interactions, primarily due to their metabolism by cytochrome P450 enzymes and central nervous system depressant effects. Concomitant use with other CNS depressants, enzyme inhibitors, or inducers can profoundly alter opioid concentrations and their pharmacological effects, leading to respiratory depression, sedation, or reduced analgesia. Clinicians must meticulously review medication lists to prevent these potentially fatal interactions[10].
Older adults are particularly vulnerable to drug-drug interactions due to polypharmacy, age-related physiological changes affecting pharmacokinetics and pharmacodynamics, and multiple comorbidities. These interactions can lead to increased adverse drug reactions, hospitalizations, and mortality. Effective prevention strategies involve medication review, deprescribing, and the use of clinical decision support systems[5].
Targeted cancer therapies, while effective, often involve complex drug regimens that can lead to significant drug-drug interactions. These interactions are particularly concerning in oncology patients who frequently take multiple medications for symptom management and comorbidities. Close monitoring and proactive management of potential interactions are crucial to optimize cancer treatment outcomes and minimize toxicity[6].
Pre-exposure prophylaxis (PrEP) for HIV prevention involves potent antiretroviral drugs, which carry a risk of pharmacokinetic drug-drug interactions with other medications. These interactions can significantly alter PrEP drug levels, potentially compromising efficacy or increasing toxicity. A thorough understanding of these interactions is crucial for optimizing PrEP regimens and ensuring patient safety, particularly for individuals on concomitant medications[9].
Drug-food interactions, though often overlooked, can substantially impact drug efficacy and safety by altering drug absorption, metabolism, or excretion. Specific foods or dietary components can modify drug pharmacokinetics or pharmacodynamics, potentially leading to therapeutic failure or increased toxicity. Educating patients about appropriate timing and dietary restrictions related to their medications is a key management strategy[7].
Pharmacogenomics holds promise for personalizing medicine by predicting individual responses to drugs, including susceptibility to adverse drug reactions and drug-drug interactions. Genetic variations in drug-metabolizing enzymes, transporters, and receptors can significantly alter drug exposure and effect. Integrating pharmacogenomic data into clinical practice could lead to more precise dosing and selection of medications, ultimately preventing harmful interactions[8].
Drug-drug interactions represent a critical challenge across diverse therapeutic areas and patient populations, often leading to altered drug concentrations, compromised efficacy, or increased toxicity. New oral anticoagulants, for instance, carry a significant risk of interactions due to their metabolic pathways, requiring careful consideration of concomitant medications to minimize adverse events. Similarly, the complex pharmacotherapy in COVID-19 patients, encompassing antivirals, immunomodulators, and supportive care drugs, makes them highly vulnerable to clinically significant interactions, necessitating vigilant monitoring. Herbal remedies, commonly perceived as benign, can profoundly interact with conventional drugs through pharmacokinetic and pharmacodynamic mechanisms, altering drug absorption, metabolism, distribution, and excretion. Direct-acting antivirals for Hepatitis C and potent antiretroviral drugs for HIV Pre-exposure Prophylaxis are prone to pharmacokinetic interactions, impacting their efficacy and safety. Older adults are particularly susceptible to drug interactions due to polypharmacy and age-related physiological changes, highlighting the need for medication reviews and deprescribing. Oncology patients on targeted therapies also face substantial interaction risks given their complex regimens and comorbidities. Moreover, opioid analgesics frequently interact due to cytochrome P450 metabolism and central nervous system depressant effects, posing risks of respiratory depression. Even drug-food interactions can significantly alter pharmacokinetics, affecting therapeutic outcomes. Pharmacogenomics offers a forward-looking approach to personalize medicine by predicting individual drug responses and preventing harmful interactions through precise dosing and medication selection.
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Journal of Integrative Oncology received 495 citations as per Google Scholar report
