Arzneimittelinteraktionen, die man kennen muss!

Arzneimittelinteraktionen (AMI) sind ein häufig unterschätztes Problem der modernen Medizin. Die Zahl älterer, multimorbider Patienten, die mehrere Wirkstoffe gleichzeitig einnehmen, nimmt stetig zu – der damit verbundene exponentielle Anstieg möglicher AMI ist fast unüberschaubar. Diese Übersicht stellt häufige, relevante AMI anhand von Beispielen dar und zeigt Strategien auf, wie sie in der Praxis frühzeitig erkannt und vermieden werden können.

• Literatur

• 1 Dechanont S, Maphanta S, Butthum B. et al. Hospital admissions/visits associated with drug-drug interactions: a systematic review and meta-analysis. Pharmacoepidemiol Drug Saf 2014; 23: 489-497 doi:10.1002/pds.3592
• 2 Cascorbi I. Drug interactions – principles, examples and clinical consequences. Dtsch Arztebl Int 2012; 109: 546-555 doi:10.3238/arztebl.2012.0546 quiz 556
• 3 Kloner RA, Goldstein I, Kirby MG. et al. Cardiovascular safety of phosphodiesterase type 5 inhibitors after nearly 2 decades on the market. Sex Med Rev 2018;
• 4 Schwartz BG, Kloner RA. Drug interactions with phosphodiesterase- 5 inhibitors used for the treatment of erectile dysfunction or pulmonary hypertension. Circulation 2010; 122: 88-95 doi:10.1161/CIRCULATIONAHA.110.944603
• 5 Pringle SD, MacEwen CJ. Severe bradycardia due to interaction of timolol eye drops and verapamil. Brit Med J 1987; 294: 155-156
• 6 de Abajo FJ. Effects of selective serotonin reuptake inhibitors on platelet function: mechanisms, clinical outcomes and implications for use in elderly patients. Drugs Aging 2011; 28: 345-367 doi:10.2165/11589340-000000000-00000
• 7 Hackam DG, Mrkobrada M. Selective serotonin reuptake inhibitors and brain hemorrhage: a meta-analysis. Neurology 2012; 79: 1862-1865 doi:10.1212/WNL.0b013e318271f848
• 8 Loke YK, Trivedi AN, Singh S. Meta-analysis: gastrointestinal bleeding due to interaction between selective serotonin uptake inhibitors and non-steroidal anti-inflammatory drugs. Aliment Pharmacol Ther 2008; 27: 31-40 doi:10.1111/j.1365-2036.2007.03541.x
• 9 Heijman J, Voigt N, Carlsson LG. et al. Cardiac safety assays. Curr Opin Pharmacol 2014; 15: 16-21 doi:10.1016/j.coph.2013.11.004 10.1016/j.coph.2013.11.004
• 10 Drew BJ, Ackerman MJ, Funk M. et al. Prevention of torsade de pointes in hospital settings: a scientific statement from the American Heart Association and the American College of Cardiology Foundation. Circulation 2010; 121: 1047-1060 doi:10.1161/CIRCULATIONAHA.109.192704
• 11 Meid AD, von Medem A, Heider D. et al. Investigating the additive Interaction of QT-prolonging drugs in older people using claims data. Drug Saf 2017; 40: 133-144 doi:10.1007/s40264-016-0477-y
• 12 Meid AD, Bighelli I, Machler S. et al. Combinations of QTc-prolonging drugs: towards disentangling pharmacokinetic and pharmacodynamic effects in their potentially additive nature. Ther Adv Psychopharmacol 2017; 7: 251-264 doi:10.1177/2045125317721662
• 13 Hohlfeld T, Saxena A, Schror K. High on treatment platelet reactivity against aspirin by non-steroidal anti-inflammatory drugs – pharmacological mechanisms and clinical relevance. Thromb Haemost 2013; 109: 825-833 doi:10.1160/TH12-07-0532
• 14 Heidbuchel H, Verhamme P, Alings M. et al. Updated European Heart Rhythm Association Practical Guide on the use of nonvitamin K antagonist anticoagulants in patients with non-valvular atrial fibrillation. Europace 2015; 17: 1467-1507 doi:10.1093/europace/euv309
• 15 Benet LZ, Hoener BA. Changes in plasma protein binding have little clinical relevance. Clin Pharmacol Ther 2002; 71: 115-121 doi:10.1067/mcp.2002.121829
• 16 Shitara Y, Hirano M, Sato H. et al. Gemfibrozil and its glucuronide inhibit the organic anion transporting polypeptide 2 (OATP2/OATP1B1:SLC21A6)-mediated hepatic uptake and CYP2C8-mediated metabolism of cerivastatin: analysis of the mechanism of the clinically relevant drug-drug interaction between cerivastatin and gemfibrozil. J Pharmacol Exp Ther 2004; 311: 228-236 doi:10.1124/jpet.104.068536
• 17 Haffner S, Thürmann PA. Which drug interactions the general practitioner should know. Med Klin 2004; 99: 137-146 doi:10.1007/s00063-004-1022-9 quiz 147
• 18 Abbas S, Ihle P, Harder S. et al. Risk of bleeding and antibiotic use in patients receiving continuous phenprocoumon therapy. A case-control study nested in a large insurance- and population-based German cohort. Thromb Haemost 2014; 111: 912-922 doi:10.1160/TH13-09-0723
• 19 Dempfle CE. Pharmacology of the new oral anticoagulants. Herz 2012; 37: 362-368 doi:10.1007/s00059-012-3616-y
• 20 Wagner J, Suessmair C, Pfister HW. Rhabdomyolysis caused by co-medication with simvastatin and clarithromycin. J Neurol 2009; 256: 1182-1183 doi:10.1007/s00415-009-5078-6
• 21 Li DQ, Kim R, McArthur E. et al. Risk of adverse events among older adults following co-prescription of clarithromycin and statins not metabolized by cytochrome P450 3A4. CMAJ 2015; 187: 174-180 doi:10.1503/cmaj.140950
• 22 Cronnolly B, Pegrum H. Fentanyl-clarithromycin interaction. BMJ Case Rep 2012;
• 23 Hall SD, Wang Z, Huang SM. et al. The interaction between St Johnʼs wort and an oral contraceptive. Clin Pharmacol Ther 2003; 74: 525-535 doi:10.1016/j.clpt.2003.08.009
• 24 Walley T, Pirmohamed M, Proudlove C. et al. Interaction of metoprolol and fluoxetine. Lancet 1993; 341: 967-968
• 25 Agewall S, Cattaneo M, Collet JP. et al. Expert position paper on the use of proton pump inhibitors in patients with cardiovascular disease and antithrombotic therapy. Eur Heart J 2013; 34: 1708-1713 doi:10.1093/eurheartj/eht042 1713a-1713b