Skip to content
Research Article Open access CC BY 3.0

Review of Drug Interactions: A Comprehensive Update

Madhav Mutalik, Dhara Sanghavi

Journal of Pharmaceutical Research International · pp. 954–980 · Published 12 Mar 2014

10.9734/BJPR/2014/8531

Abstract

Prescribing multiple medications predisposes to possibilities of occurrence of drug interactions. Various different terminology and ways exist to classify or arrange drug interactions. Drugs interact with other drugs, foods, beverages and herbs; outside or inside the body. Knowledge of In vitro interactions is essential to avoid loss of activity of drugs before administration. Although every theoretical drug interaction may not manifest in practice, drug interaction is a prominent cause of adverse or undesired events related to drug administration. Amongst the herbs, St. John’s wort has a potential of producing significant drug interactions due to its capacity to induce metabolism of number of drugs. In vivo interactions at pharmacokinetic level affect absorption, distribution, biotransformation or excretion of drugs. Induction or inhibition of cytochrome P450 (CYP450) enzymes forms a major basis of drug interactions. Induction of metabolism of a substrate drug leads to treatment failure. Inhibition of metabolism leads to serious interactions by aggravating toxicity of substrate drugs. As compared to induction, inhibition is a fairly rapid process, and number of precipitant drugs which inhibit the metabolism is much more than that of inducers. Role of drug transporters, especially P-glycoprotein (P-gp), in causation of drug interactions is being increasingly identified. P-gp affects absorption, distribution and excretion, and hence plays a major role in pharmacokinetic drug interactions. Additionally, P-gp works hand in hand with CYP450 enzymes. In pharmacodynamic interactions, the drugs synergise or antagonise the effect at the level of target of action. Clinically beneficial and reparative drug interactions are explored to obtain useful drug combinations. Extensive research has led to development of a large number of In vitro and In vivo methods to detect and predict drug interactions. Appropriate awareness and knowledge of possible drug interactions is crucial in prevention of drug interactions and their consequences.

Drug interactions transporter P-glycoprotein methods for detection CYP450

References (24)

  1. 1 Incidence of Adverse Drug Reactions in Hospitalized Patients [DOI]
  2. 2 Interindividual variations in human liver cytochrome P-450 enzymes involved in the oxidation of drugs, carcinogens and toxic chemicals: studies with liver microsomes of 30 Japanese and 30 Caucasians. [DOI]
  3. 3 Comparison of cytochrome P450 (CYP) genes from the mouse and human genomes, including nomenclature recommendations for genes, pseudogenes and alternative-splice variants [DOI]
  4. 4 Herb–Drug Interactions [DOI]
  5. 5 Interactions Between Herbal Medicines and Prescribed Drugs [DOI]
  6. 6 Pharmacokinetic drug-drug interaction and their implication in clinical management.
  7. 7 Concise Review: Clinical Relevance of Drug–Drug and Herb–Drug Interactions Mediated by the ABC Transporter ABCB1 (MDR1, P-glycoprotein) [DOI]
  8. 8 Gene structure of CYP3A4 , an adult‐specific form of cytochrome P 450 in human livers, and its transcriptional control [DOI]
  9. 9 In Vitro Approaches to Predicting Drug Interactions In Vivo [DOI]
  10. 10 Prediction of In Vivo Drug-Drug Interactions from In Vitro Data [DOI]
  11. 11 Prevalence and Risk Factors for Clinically Significant Drug Interactions with Antiretroviral Therapy [DOI]
  12. 12 Drug Interaction and Pharmacist [DOI]
  13. 13 Clinically Significant Drug Interactions [DOI]
  14. 14 Pain management for dentists: the role of ibuprofen.
  15. 15 Prevalence of potentially hazardous drug interactions amongst Australian veterans [DOI]
  16. 16 Prevalence of the Prescription of Potentially Interacting Drugs [DOI]
  17. 17 Phenobarbital/Lamotrigine Coadministration–Induced Blood Dyscrasia in a Patient with Epilepsy [DOI]
  18. 18 Relative expression of cytochrome P450 isoenzymes in human liver and association with the metabolism of drugs and xenobiotics [DOI]
  19. 19 Assignment of the human cytochrome P-450 nifedipine oxidase gene (CYP3A4) to chromosome 7 at band q22.1 by fluorescencein situ hybridization [DOI]
  20. 20 Interactions among Low Dose of Methotrexate and Drugs Used in the Treatment of Rheumatoid Arthritis [DOI]
  21. 21 Psychic Disturbances Associated with Sodium Valproate Plus Levetiracetam [DOI]
  22. 22 Clinically Important Drug Interactions [DOI]
  23. 23 Clinically Desirable Drug Interactions [DOI]
  24. 24 Drug interactions: a review and update [DOI]

Cited by 7

Polypharmacy in Psychiatry: An In-depth Examination of Drug-drug Interactions and Treatment Challenges

Devank Shekho, Ritika Mishra, Raj Kamal · Current Pharmaceutical Design · 2024

Antimycolytic agents: fungistatic and fungicide

Gudisa Bereda · Annals of Dermatological Research · 2022

Multi-Relational Hierarchical Embedding with Multi-Graph Neural Networks for Drug-Drug Interaction Prediction

Yanan Wang, Jiankang Liu, Yuhan Zhao · 2025

Showing 3 of 7 known citations — external sources report more than can currently be individually listed.

Related research

Article metrics

Real usage data collected on this platform.

14

Page views

0

PDF downloads

6

Outbound clicks

7

Citations

Views over time

Views by country

Approximate, from request IP at view time — not citizenship or institution. Countries with fewer than 5 views are grouped as "Other".

Traffic sources

Referring site, by host.

Views and downloads exclude known bots/crawlers. Citations combines this platform's own DOI-resolved index with each external source's own reported total — see Cited by above for individually listed citing works. Last refreshed 0 seconds ago.