Disagreement among drug compendia on inclusion and ratings of drug-drug interactions

Fulda, Thomas R.; Valuck, Robert J.; Zanden, Jeanne Vander; Parker, Sandi; Byrns, Patricia J.

doi:10.1016/s0011-393x(00)80036-3

Cited by 73 publications

(60 citation statements)

References 2 publications

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“…Three previous studies have examined the concordance among American drug interaction compendia. Fulda et al [14] compared the inclusion of drug interactions for five drug classes in five American drug interactions compendia. Individual interactions were rarely listed in more than one or two of the compendia.…”

Section: Discussionmentioning

confidence: 99%

Comparative assessment of four drug interaction compendia

Vitry

2006

Brit J Clinical Pharma

139

107

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AimsTo assess the consistency of inclusion and grading of major drug interactions for 50 drugs in four leading international drug interaction compendia. MethodsFour international drug interaction compendia were compared: the drug interactions appendix of the British National Formulary, the interaction supplement in the French drug compendium Vidal, and two US drug interaction compendia, Drug Interaction Facts and the Micromedex (Drug-Reax) program. Major interactions were defined as potentially hazardous in BNF or with the warning 'contraindication' or 'avoid' in Vidal or with the significance grading 1 or 2 in DIF. Major interactions for a list of 50 drugs were searched in all four compendia. ResultsA total of 1264 interactions meeting the inclusion criteria were identified for these 50 drugs. After deletion of 169 duplicates, 1095 interactions were included in the analysis. Of the drug interactions classified as major in any one compendium between 14% and 44% were not listed in the other compendia. The grading systems used for the severity and the quality of the supporting evidence in Micromedex and DIF were inconsistent. ConclusionsThere is a lack of consistency in the inclusion and grading of drug interactions of major significance for 50 drugs across the four drug compendia examined. This may reflect the lack of standardization of the terminology used to classify drug interactions and the lack of good epidemiological evidence on which to base the assessment of the clinical relevance of drug interactions.

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Section: Discussionmentioning

confidence: 99%

Comparative assessment of four drug interaction compendia

Vitry

2006

Brit J Clinical Pharma

139

107

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“…The authoritative compendium [38,39] classify existing documentation in the literature in five levels: established, probable, suspected, possible or unlikely, and severity of adverse effects in three levels: major, moderate or minor. Based on a combination of these two criteria, clinical significance of DDIs was ranked by number, from 1 to 5.…”

Section: Identification and Analysis Of Potential Ddismentioning

confidence: 99%

“…The compendium was used to identify clinical significant potential DDIs is one of the primary sources for drug information, and other studies used other sources. But, some studies presented disagreement among authoritative drug compendia in listing as well as ranking clinical significance of DDIs [38,39]. Because of these differences performing DDIs prevalence studies presents challenge making it difficult to compare results across studies.…”

Section: Limitationsmentioning

confidence: 99%

Prevalence and predictors of potential drug-drug interactions

Nikolic¹,

Janković

Stojanov³

et al. 2014

Open Medicine

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“…These reference sources are based on DDI studies using multiple methodologies of variable quality in a range of experimental models. Studies may be conducted in silico, in vitro or in vivo, the latter comprising formal pharmacokinetic interaction studies in animals and humans, or as reports of clinical observations.The assessment of these studies is seldom explicit, and there is lack of consistency and considerable disparity between resources [2][3][4][5][6]. For example, in a recent study of four international drug interaction compendia, between 14% and 44% of the interactions classified as major in any one compendium were not listed in other compendia [4].Thus, interpreting the clinical relevance of a given perpetrator is often difficult, particularly for healthcare providers subject to 'information overload' and 'alert fatigue' [7,8].…”

Section: Introductionmentioning

confidence: 99%

Perpetrators of pharmacokinetic drug–drug interactions arising from altered cytochrome P450 activity: a criteria‐based assessment

Polasek

Lin

Miners

et al. 2011

Brit J Clinical Pharma

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WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT• Many drugs inhibit or induce cytochrome P450 enzymes (CYP) to cause clinically significant changes in the concentrations of other drugs, i.e.'perpetrate' pharmacokinetic drug-drug interactions (PK-DDIs).• Tables that list the substrates, inhibitors and inducers of CYP are common, but they lack consistency and are constructed from evidence of variable quality. WHAT THIS STUDY ADDS• This is the first study to catalogue important perpetrators of PK-DDIs using objective criteria and clinical pharmacokinetic drug interaction studies. This information is intended to inform clinical decisions on PK-DDIs.• Existing tables of CYP inhibitors and inducers have low sensitivity and low positive predictive value in identifying the major perpetrators of PK-DDIs. • Several drugs were identified which potentially perpetrate CYP-mediated PK-DDIs, but quality clinical pharmacokinetic interaction studies are lacking. This information may be used to inform future research. AIMSTo catalogue the perpetrators of CYP-mediated pharmacokinetic drug-drug interactions (PK-DDIs) using clinically relevant criteria, and to compare this with an analogous catalogue. METHODSCandidate inhibitors and inducers of CYP1A2, CYP2C9, CYP2C19, CYP2D6 and CYP3A ('perpetrators') were evaluated using published clinical pharmacokinetic interaction studies. Studies were selected on the basis of Նsix human subjects, use of a validated in vivo probe substrate for the CYP enzyme, and clinically relevant dosing. Inhibitors were described according to the FDA classifications of strong, moderate or weak, whereas inducers were classified as major (Նtwofold decrease in AUC) or weak (

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Disagreement among drug compendia on inclusion and ratings of drug-drug interactions

Cited by 73 publications

References 2 publications

Comparative assessment of four drug interaction compendia

Comparative assessment of four drug interaction compendia

Prevalence and predictors of potential drug-drug interactions

Perpetrators of pharmacokinetic drug–drug interactions arising from altered cytochrome P450 activity: a criteria‐based assessment

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