Risk factors of drug-induced diseases. Part 3. Drug-drug and drug-food interactions

DOI: https://dx.doi.org/10.18565/pharmateca.2022.1.10-18

D.A. Sychev (1), O.D. Ostroumova (1), A.P. Pereverzev (1), M.S. Chernyaeva (2), A.I. Kochetkov (1), M.V. Klepikova (1), E.Yu. Ebzeeva (1), V.A. De (1)

1) Russian Medical Academy of Continuing Professional Education, Moscow, Russia; 2) Central State Medical Academy, Moscow, Russia
Polypharmacy increases the risk of drug-drug interactions, leading to poor effectiveness and side effects. Drug-drug interactions can be divided into two main groups: pharmacokinetic and pharmacodynamic. Drugs, food, drinks can change the effect of drugs, affect pharmacodynamic mechanisms by synergistic, additive or antagonistic effects or pharmacokinetic processes such as absorption, metabolism and excretion, which leads to a decrease in the effectiveness of drugs or an increase in its toxicity. Drugs can also alter the ability to absorb essential to health nutrients. One of the main causes of drug-drug interactions is the induction or inhibition of cytochrome P450 (CYP450) enzymes. The carriers of drugs, especially P-glycoprotein (P-gp), can cause interactions between drugs and therefore it plays an important role in the pharmacokinetic drug-drug interactions. Further study is needed on drug-food interactions. However, it is known that widely-used drugs (such as sugar-lowering, antihypertensive drugs, including diuretics, renin-angiotensin-aldosterone system inhibitors, β-blockers, analgesics, etc.) usually prescribed without taking into account meal times. Moreover, it’s known about drug-herbs interaction and interactions with dietary supplements. Drug-drug interactions is one of the most important risk factors for drug-induced diseases because the diagnosis of drug-drug interactions sometimes is difficult due to different pharmacological mechanisms. Clinicians should always evaluate both patient-related factors (genetic polymorphism, age, sex, physiologic status, etc.) and drug-related factors. Knowing the significant drug-drug interactions can help the clinician to prevent side effects and drug-induced diseases and optimize pharmacotherapy.

About the Autors

Corresponding author: Olga D. Ostroumova, Dr. Sci. (Med.), Professor, Head of the Chair of Therapy and Polymorbid Diseases n.a. Academician M.S. Vovsi, Russian Medical Academy of Continuing Professional Education, Moscow, Russia; ostroumova.olga@mail.ru

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