Drug Interactions: A Review

  • Prasad Krishnamurthy
  • Sunil Kadam
  • Jacob Matthews
Keywords: Drug Interaction, Adverse Drug Reaction, Pharmacokinetics


Increased use of drugs as well as polypharmacy has led to increase in incidence of drug interactions. These interactions may lead to medically significant as well as life threatening complications. Not all kind of interactions that can occur with a drug are known. The data in reference safety documents, published literature and safety databases is also limited. Some drugs may also react to certain foods or beverages if taken concomitantly. Most of the interactions come into picture during post-marketing phase of a drug. Latest versions of labelling documents by the manufacturers are informative but not necessarily for newly approved drugs. It is imperative for the healthcare professionals to check for known interactions while prescribing multiple drugs. Detailed diet routine and ongoing medications of subjects also need to be taken into consideration.


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Author Biographies

Prasad Krishnamurthy

M. Pharm, Ex-Pharmaceutical Consultant, Konidena, Andhra Pradesh, India

Sunil Kadam

BDS, Consultant Dental Practitioner, New Delhi

Jacob Matthews

B. Pharm, Mukteswaram, Andhra Pradesh, India


Thürmann PA. Methods and systems to detect adverse drug reactions in hospitals. Drug Saf. 2001;24(13):961-8. https://doi.org/10.2165/00002018-200124130-00003. PMID: 11735652.

Köhler GI, Bode-Böger SM, Busse R, Hoopmann M, Welte T, Böger RH. Drug-drug interactions in medical patients: effects of in-hospital treatment and relation to multiple drug use. Int J Clin Pharmacol Ther. 2000 Nov;38(11):504-13. https://doi.org/10.5414/cpp38504. PMID: 11097142.

Jankel CA, Fitterman LK. Epidemiology of drug-drug interactions as a cause of hospital admissions. Drug Saf. 1993 Jul;9(1):51-9. https://doi.org/10.2165/00002018-199309010-00005. PMID: 8347291.

Fleisher D, Li C, Zhou Y, Pao LH, Karim A. Drug, meal and formulation interactions influencing drug absorption after oral administration. Clinical implications. Clin Pharmacokinet. 1999 Mar;36(3):233-54. https://doi.org/10.2165/00003088-199936030-00004.

Maskalyk J. Grapefruit juice: potential drug interactions. CMAJ. 2002;167(3):279-80.

Ducharme MP, Warbasse LH, Edwards DJ. Disposition of intravenous and oral cyclosporine after administration with grapefruit juice. Clin Pharmacol Ther. 1995;57(5):485-91. https://doi.org/10.1016/0009-9236(95)90032-2.

Tanigawara Y. Role of P-glycoprotein in drug disposition. Ther Drug Monit. 2000;22(1):137-40. https://doi.org/10.1097/00007691-200002000-00029.

Dürr D, Stieger B, Kullak-Ublick GA, Rentsch KM, Steinert HC, Meier PJ, Fattinger K. St John's Wort induces intestinal P-glycoprotein/MDR1 and intestinal and hepatic CYP3A4. Clin Pharmacol Ther. 2000 Dec;68(6):598-604. https://doi.org/10.1067/mcp.2000.112240.

Fugh-Berman A, Ernst E. Herb-drug interactions: review and assessment of report reliability. Br J Clin Pharmacol. 2001 Nov;52(5):587-95. doi: 10.1046/j.0306-5251.2001.01469.x.

Pfrunder A, Schiesser M, Gerber S, Haschke M, Bitzer J, Drewe J. Interaction of St John's wort with low-dose oral contraceptive therapy: a randomized controlled trial. Br J Clin Pharmacol. 2003 Dec;56(6):683-90. https://doi.org/10.1046/j.1365-2125.2003.02005.x.

Rolan PE. Plasma protein binding displacement interactions--why are they still regarded as clinically important? Br J Clin Pharmacol. 1994;37(2):125-8. https://doi.org/10.1111/j.1365-2125.1994.tb04251.x.

Perri D, Ito S, Rowsell V, Shear NH. The kidney--the body's playground for drugs: an overview of renal drug handling with selected clinical correlates. Can J Clin Pharmacol. 2003;10(1):17-23.

Penning-van Beest FJ, van Meegen E, Rosendaal FR, Stricker BH. Drug interactions as a cause of overanticoagulation on phenprocoumon or acenocoumarol predominantly concern antibacterial drugs. Clin Pharmacol Ther. 2001;69(6):451-7. https://doi.org/10.1067/mcp.2001.115723.

DOI: 10.26440/0602.05539
Published: 2022-05-31
How to Cite
Prasad Krishnamurthy, Sunil Kadam, Jacob Matthews. Drug Interactions: A Review. IHRJ [Internet]. 2022May31 [cited 2022Jul.2];6(2):RV1-RV5. Available from: https://ihrjournal.com/ihrj/article/view/539