Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2014 Jul;7(4):533-44.
doi: 10.1586/17512433.2014.910111. Epub 2014 Apr 19.

Understanding and preventing drug-drug and drug-gene interactions

Cara Tannenbaum  1 , Nancy L Sheehan
Affiliations
Review

Understanding and preventing drug-drug and drug-gene interactions

Cara Tannenbaum et al. Expert Rev Clin Pharmacol. 2014 Jul.

Abstract

Concomitant administration of multiple drugs can lead to unanticipated drug interactions and resultant adverse drug events with their associated costs. A more thorough understanding of the different cytochrome P450 isoenzymes and drug transporters has led to new methods to try to predict and prevent clinically relevant drug interactions. There is also an increased recognition of the need to identify the impact of pharmacogenetic polymorphisms on drug interactions. More stringent regulatory requirements have evolved for industry to classify cytochrome inhibitors and inducers, test the effect of drug interactions in the presence of polymorphic enzymes, and evaluate multiple potentially interacting drugs simultaneously. In clinical practice, drug alert software programs have been developed. This review discusses drug interaction mechanisms and strategies for screening and minimizing exposure to drug interactions. We also provide future perspectives for reducing the risk of clinically significant drug interactions.

Keywords: cytochrome-mediated drug interactions; drug transporters; drug-drug-gene interactions; pharmacogenomics; polypharmacy.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Huang SM, Strong JM, Zhang L. New era in drug interaction evaluation: US FDA update on CYP enzymes, transporters, and the guidance process. J Clin Pharmacol. 2008;48(6):662–70. - PubMed

    2. This study provides a succinct account of the historical events leading to the recognition that drugs that share the same CYP450 metabolic pathways could interact and cause serious adverse events. Also highlights the most recent requirements for industry to characterize potential CYP450 drug–drug interactions during the drug preapproval process.

    1. Monahan BP, Ferguson CL, Killeavy ES. Torsades de pointes occurring in association with terfenadine use. JAMA. 1990;264(21):2788–90. - PubMed
    1. US FDA Guidance for Industry: drug metabolism/drug interactions in the drug development process: studies in vitro. 1997 www.fda.gov/cder/guidance/clin3.pdf Available from: [Last accessed 21 February 2013]
    1. US FDA Guidance for Industry: in vivo metabolism/drug interaction: study design, data analysis and recommendation for dosing and labeling. 1999 www.fda.gov/cder/guidance/2635fnl.pdf Available from: [Last accessed 21 February 2013]
    1. Huang SM, Temple R, Throckmorton DC, Lesko LJ. Drug interaction studies: study design, data analysis, and implications for dosing and labeling. Clin Pharmacol Ther. 2007;81(2):298–304. - PubMed

Publication types

MeSH terms

Substances