Table 5 Most frequent pDDIs among cancer patients
Drug-drug interaction | Frequency | Severity | Evidence | Potential adverse outcome |
|---|---|---|---|---|
Dexamethasone + Vincristine | 228 | Major | Fair | Decreased vincristine plasma concentration. |
Doxorubicin + Dexamethasone | 164 | Major | Fair | Reduced doxorubicin exposure. |
Ondansetron + Prochlorperazine | 116 | Major | Fair | Increased risk of QT interval prolongation. |
Cyclophosphamide + Doxorubicin | 105 | Major | Fair | High risk of cardiomyopathy. |
Ciprofloxacin + Dexamethasone | 102 | Moderate | Excellent | Increased risk for tendon rupture. |
Ciprofloxacin + Ondansetron | 89 | Major | Fair | Increased risk of QT interval prolongation. |
Ciprofloxacin + Prochlorperazine | 83 | Major | Fair | Increased risk of QT interval prolongation. |
Cyclophosphamide + Ondansetron | 75 | Moderate | Good | Decreased cyclophosphamide systemic exposure. |
Allopurinol + Cyclophosphamide | 66 | Major | Good | Cyclophosphamide toxicity (bone marrow suppression, nausea, vomiting). |
Metoclopramide + Tramadol | 48 | Major | Fair | Increased risk of seizures. |
Ciprofloxacin + Doxorubicin | 33 | Major | Fair | Increased doxorubicin exposure. |
Calcium Chloride + Ciprofloxacin | 32 | Moderate | Good | Decreased ciprofloxacin efficacy. |
Ondansetron + Tramadol | 31 | Moderate | Excellent | Reduced efficacy of tramadol. |
Tropisetron + Tramadol | 24 | Major | Fair | Increased risk of serotonin syndrome. |
Fluorouracil + Leucovorin | 23 | Moderate | Good | Increased concentrations of 5-fluorouracil and fluorouracil toxicity (granulocytopenia, anemia, thrombocytopenia, stomatitis, vomiting). |
Asparaginase + Vincristine | 19 | Major | Fair | Increased vincristine exposure causing neurotoxicity. |
Cisplatin + Docetaxel | 14 | Moderate | Excellent | Increased risk of neuropathy. |
Methotrexate + Omeprazole | 13 | Major | Good | Increased concentration of methotrexate and its metabolite and an increased risk of methotrexate toxicity. |
Cisplatin + Doxorubicin | 11 | Major | Good | Increased risk of Secondary malignancy i.e. secondary leukemia. |
Fluconazole + Metronidazole | 10 | Major | Fair | Increased risk of QT interval prolongation and arrhythmias. |