A comprehensive evaluation of potentially significant drug-drug, drug-herb, and drug-food interactions among cancer patients receiving anticancer drugs

Koni, Amer; Nazzal, Maisa A; Suwan, Bushra A; Sobuh, Samah S; Abuhazeem, Najiya T; Salman, Asil N; Salameh, Husam; Amer, Riad; Zyoud, Sa’ed H.

doi:10.1186/s12885-022-09649-3

Cited by 4 publications

(4 citation statements)

References 35 publications

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“…In a US study to evaluate drug information knowledge retention, the pharmacists' knowledge decreased one year after the educational courses were provided; therefore, continual education is a key to safe pharmacy practices 9 . On the other hand, another American study revealed a significant improvement in the knowledge and score of pharmacists in drug interactions after the educational programs 23 .…”

Section: Discussionmentioning

confidence: 97%

“…The study's findings revealed that community pharmacists in Palestine have an acceptable knowledge about DDI compared to other regional studies in Saudi Arabia, Lebanon, and Jordan., 12,13,22 , even though a study describing the prevalence of DIs in cancer patients in Palestine showed a prevalence of DDIs was 88.1% 23 . This is incongruent with a national study that evaluated community pharmacists' knowledge about the potential DFI, where the results showed they did not have the appropriate DFI knowledge.…”

Section: Discussionmentioning

confidence: 99%

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Exploring the Role of Community Pharmacists in Drug Interactions: A Cross-Sectional Study in Palestine

Naseef,

Ayyash,

Almtour

et al. 2023

Bulletin of Pharmaceutical Sciences Assiut University

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Objective: This study aims to evaluate community pharmacists' knowledge, attitudes, and practices about drug-drug interactions (DDIs) and drug-food/herbs interactions (DFIs) in Palestine. Method: A cross-sectional study using a self-administered questionnaire including thirty questions was conducted among community pharmacists to assess the pharmacists' knowledge, attitudes, and practices related to DDIs and DFIs. The t-test, ANOVA, and chisquare tests were used to find the associations with characteristics and demographics. The data were analyzed using SPSS version 22. Results: A total of 361 participants completed the questionnaire; most participants (49.6%) have bachelor's degrees in pharmacy and 26.0% have a doctor of pharmacy degree. 20.8% of participants have been a pharmacist for ten years or longer, while 10.2% have been a pharmacists from 7 to 9 years. Pharmacists' DIs knowledge level was acceptable; their DFIs knowledge was higher than their DDIs knowledge. Pharmacists with long experience working in chain pharmacies with internet services significantly had better knowledge about DDI and DFI. Pharmacists' attitude toward the importance of recognizing DIs was positive, whereas their practice reflected less positivity. Conclusion: Community pharmacists in Palestine have acceptable knowledge of drug interactions. However, their DFIs knowledge is higher than their DDIs knowledge, and they have favorable attitudes toward DIs, whereas their practice was negative. However, community pharmacists need to improve their knowledge of DDIs and DFIs and stay current with new drug interactions.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Exploring the Role of Community Pharmacists in Drug Interactions: A Cross-Sectional Study in Palestine

Naseef,

Ayyash,

Almtour

et al. 2023

Bulletin of Pharmaceutical Sciences Assiut University

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“…However, combining multiple drugs can generate drug interactions in both pharmacodynamics and pharmacokinetics. A comprehensive evaluation has shown that the number of potential DDIs significantly increases with the number of comorbidities and drugs used in cancer patients ( Koni et al, 2022 ). This can impact treatment outcomes by increasing the incidence of drug-related adverse reactions or reducing efficacy.…”

Section: Discussionmentioning

confidence: 99%

In vivo evaluation of the pharmacokinetic interactions between almonertinib and rivaroxaban, almonertinib and apixaban

Wang,

Li,

et al. 2023

Front. Pharmacol.

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Background: Almonertinib, a third-generation epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI), is commonly used as a first-line treatment for non-small cell lung cancer (NSCLC) patients with EGFR T790M mutations. Rivaroxaban and apixaban are a selective, direct factor Xa inhibitor used to treat venous thromboembolism (VTE), which is a frequent complication of NSCLC. Rivaroxaban and apixaban are substrates of CYP3A4, P-gp and BCRP, whereas almonertinib is an inhibitor of P-gp and BCRP. Rivaroxaban or apixaban are often prescribed together with almonertinib in NSCLC patients, but clear information on pharmacokinetic drug interaction is lacking. Therefore, this study aimed to unravel the extent of interactions between almonertinib-rivaroxaban and almonertinib apixaban in rats, and whether the pharmacokinetic interaction can be mitigated by rivaroxaban and apixaban dose adjustment.Methods: Rats were divided into ten groups (n = 6) that received rivaroxaban (2 mg/kg) (group 1), apixaban (0.5 mg/kg) (group 2), almonertinib (15 mg/kg) (group 3, group 4), almonertinib with rivaroxaban (2 mg/kg) (group 5), almonertinib with rivaroxaban (1 mg/kg) (group 6), almonertinib with apixaban (0.5 mg/kg) (group 7), almonertinib with apixaban (0.25 mg/kg) (group 8), rivaroxaban (2 mg/kg) with almonertinib (group 9), apixaban (0.5 mg/kg) with almonertinib (group 10). The concentrations of drugs were determined by an ultra-performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS). The levels of messenger RNA were determined using quantitative real-time polymerase chain reaction (qRT-PCR).Results and Discussion: The results indicate that almonertinib increased the Cmax and AUC0-t of 2 mg/kg rivaroxaban by 3.30 and 3.60-fold, 1 mg/kg rivaroxaban by 1.28 and 1.90-fold. Almonertinib increased the Cmax and AUC0-t of 0.5 mg/kg apixaban by 2.69 and 2.87-fold, 0.25 mg/kg apixaban by 2.19 and 2.06-fold. In addition, rivaroxaban also increased systemic exposure to almonertinib. The results of qRT-PCR showed that almonertinib reduced the expression of Cyp3a1 in liver and intestine, and Abcb1a, Abcg2 in intestine and kidney. The pharmacokinetic results suggest that it is important to take special care of the interactions of these drugs in clinical applications.

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“…However, combining multiple drugs may alter the drug profiles on pharmacodynamics and pharmacokinetics attributed to drug interactions. In a comprehensive evaluation [ 36 ], the prevalence of DDIs was 88.1% in cancer patients, which increased with the number of comorbidities and drugs used. Consequently, it diminishes the patient’s quality of life by reducing efficacy or increasing the drug-related adverse effects.…”

Section: Discussionmentioning

confidence: 99%

Development of UPLC-MS/MS Method to Study the Pharmacokinetic Interaction between Sorafenib and Dapagliflozin in Rats

et al. 2022

Molecules

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Sorafenib (SOR), an inhibitor of multiple kinases, is a classic targeted drug for advanced hepatocellular carcinoma (HCC) which often coexists with type 2 diabetes mellitus (T2DM). Dapagliflozin (DAPA), a sodium–glucose cotransporter-2 inhibitor (SGLT2i), is widely used in patients with T2DM. Notably, co-administration of SOR with DAPA is common in clinical settings. Uridine diphosphate-glucuronosyltransferase family 1 member A9 (UGT1A9) is involved in the metabolism of SOR and dapagliflozin (DAPA), and SOR is the inhibitor of UGT1A1 and UGT1A9 (in vitro). Therefore, changes in UGT1A9 activity caused by SOR may lead to pharmacokinetic interactions between the two drugs. The objective of the current study was to develop an ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method for the simultaneous determination of SOR and DAPA in plasma and to evaluate the effect of the co-administration of SOR and DAPA on their individual pharmacokinetic properties and the mechanism involved. The rats were divided into four groups: SOR (100 mg/kg) alone and co-administered with DAPA (1 mg/kg) for seven days, and DAPA (1 mg/kg) alone and co-administered with SOR (100 mg/kg) for seven days. Liquid–liquid extraction (LLE) was performed for plasma sample preparation, and the chromatographic separation was conducted on Waters XSelect HSS T3 column with a gradient elution of 0.1% formic acid and 5 mM ammonium acetate (Phase A) and acetonitrile (Phase B). The levels of Ugt1a7 messenger RNA (mRNA) were determined in rat liver and intestine using quantitative real-time polymerase chain reaction (qRT-PCR). The method was successfully applied to the study of pharmacokinetic interactions. DAPA caused a significant decrease in the maximum plasma concentrations (Cmax) and the area under the plasma concentration–time curves (AUC0–t) of SOR by 41.6% and 50.5%, respectively, while the apparent volume of distribution (Vz/F) and apparent clearance (CLz/F) significantly increased 2.85- and 1.98-fold, respectively. When co-administering DAPA with SOR, the AUC0–t and the elimination half-life (t1/2Z) of DAPA significantly increased 1.66- and 1.80-fold, respectively, whereas the CLz/F significantly decreased by 40%. Results from qRT-PCR showed that, compared with control, seven days of SOR pretreatment decreased Ugt1a7 expression in both liver and intestine tissue. In contrast, seven days of DAPA pretreatment decreased Ugt1a7 expression only in liver tissue. Therefore, pharmacokinetic interactions exist between long-term use of SOR with DAPA, and UGT1A9 may be the targets mediating the interaction. Active surveillance for the treatment outcomes and adverse reactions are required.

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A comprehensive evaluation of potentially significant drug-drug, drug-herb, and drug-food interactions among cancer patients receiving anticancer drugs

Cited by 4 publications

References 35 publications

Exploring the Role of Community Pharmacists in Drug Interactions: A Cross-Sectional Study in Palestine

Exploring the Role of Community Pharmacists in Drug Interactions: A Cross-Sectional Study in Palestine

In vivo evaluation of the pharmacokinetic interactions between almonertinib and rivaroxaban, almonertinib and apixaban

Development of UPLC-MS/MS Method to Study the Pharmacokinetic Interaction between Sorafenib and Dapagliflozin in Rats

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