Prevalence of potential drug-drug interactions in cancer patients treated with oral anticancer drugs

R. W.F. Van Leeuwen*, D. H.S. Brundel, C. Neef, T. Van Gelder, R. H.J. Mathijssen, D. M. Burger, F. G.A. Jansman

*Corresponding author for this work

Research output: Contribution to journalReview articlePopular

201 Citations (Scopus)
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Abstract

Background: Potential drug-drug interactions (PDDIs) in patients with cancer are common, but have not previously been quantified for oral anticancer treatment. We assessed the prevalence and seriousness of potential PDDIs among ambulatory cancer patients on oral anticancer treatment. Methods: A search was conducted in a computer-based medication prescription system for dispensing oral anticancer drugs to outpatients in three Dutch centres. Potential drug-drug interactions were identified using electronic (Drug Interaction Fact software) and manual screening methods (peer-reviewed reports).Results:In the 898 patients included in the study, 1359 PDDIs were identified in 426 patients (46%, 95% confidence interval (CI)=42-50%). In 143 patients (16%), a major PDDI was identified. The drug classes most frequently involved in a major PDDI were coumarins and opioids. The majority of cases concerned central nervous system interactions, PDDIs that can cause gastrointestinal toxicity and prolongation of QT intervals. In multivariate analysis, concomitant use of more drugs (odds ratio (OR)=1.66, 95% CI=1.54-1.78, P<0001) and genito-urinary cancer (OR=0.25, 95% CI=0.12-0.52, P<0001) were risk factors. Conclusion: Potential drug-drug interactions are very common among cancer patients on oral cancer therapy. Physicians and pharmacists should be more aware of these potential interactions.

Original languageEnglish
Pages (from-to)1071-1078
Number of pages8
JournalBritish Journal of Cancer
Volume108
Issue number5
DOIs
Publication statusPublished - 19 Mar 2013

Bibliographical note

Funding Information:
We would like to thank all participating (hospital) pharmacists in the Maastricht University Medical Center, Radboud University Nijmegen Medical Center and Deventer Hospital for their contributions to in this study. We also thank Patty Nelemans (epidemiologist, Maastricht University Medical Center) for her critical review of methods used, Hans Kneefel for the graphical design of the figures, and Stacy Crow (pharmD) for proof-reading and editing the manuscript. This study was supported by the Maastricht University Medical Center. The funding source had no role in study design, data collection, data analysis, data interpretation, or writing of the manuscript. All authors had full access to the raw data of the study. The corresponding author had the final responsibility for the decision to submit the data for publication.

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