Review of pharmacological interactions of oral anticancer drugs provided at pharmacy department

Abstract: Objective: To identify the pharmacologic interactions of oral anti-cancer drugs provided at an outpatient clinic. Material and methods: Anti-cancer drugs included in the Phamacotherapeutic Guideline of the Hospital were identified. A literature search was carried out on the pharmacolog...

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Bibliographic Details
Main Authors:	E. Sánchez Gómez, Y. Arco Prados
Format:	Article
Language:	English
Published:	Grupo Aula Médica 2014-07-01
Series:	Farmacia Hospitalaria
Subjects:	Abstract: Objective: To identify the pharmacologic interactions of oral anti-cancer drugs provided at an outpatient clinic. Material and methods: Anti-cancer drugs included in the Phamacotherapeutic Guideline of the Hospital were identified. A literature search was carried out on the pharmacologic interactions in MEDLINE® and EMBASE® (with the filer language English or Spanish and the descriptors: “name of the anti-cancer drug” AND (“drug interactions” OR “pharmacokinetic”)) Up-to-date® MICROMEDEX® and the drug information sheet for the EMA and the FDA. Information was also gathered from the abstract presented to European and Spanish scientific meetings for the last 4 years. When an interaction was analyzed and had clinical relevance the best pharmacotherapeutic interaction-free alternative was sought. Results: Twenty-three drugs were identified of which Chlorambucil Fludarabine Lenalidomide Melphalan and Thalidomide were the active compounds with the lowest likelihood of producing a pharmacologic interaction. Tyrosine kinase inhibitors (particularly Erlotinib Imatinib Lapatinib and Pazopanib) are the drugs with highest number of pharmacologic interactions described many of them with severe clinical consequences with increases and decreases of the plasma levels of anti-cancer drugs. The active compounds identified that may have pharmacologic interactions with anticancer drugs were mainly: Allopurinol Amiodarone Carbamazepine Dabigatran Digoxin Spironolactone Phenytoin Itraconazol Repaglinide Silodosin Tamoxifen Verapamil and Warfarin. Pharmacologic interactions through the cytochrome P450 1A2 2D6 2C8 2C9 3A4 were the most important for tyrosine kinase inhibitors. Other non-pharmacologic compounds with an important potential of producing relevant pharmacologic interaction were immunomodulators (Echinacea extracts) and Hypericum perforatum. Conclusions: Oral anticancer drugs have numerous pharmacologic interactions that should be monitored during pharmacotherapy. Given its position Pharmacokinetics ; Pharmacologic interaction Out-patients ; Oral chemotherapy Pharmacy Department

Review of pharmacological interactions of oral anticancer drugs provided at pharmacy department

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