Potential for drug-drug interactions in treating cancer-related nausea and distress

J Oncol Pharm Pract. 2011 Dec;17(4):403-8. doi: 10.1177/1078155210384301. Epub 2010 Oct 1.

Abstract

Purpose: To determine the extent and severity of drug-drug interactions between anti-emetics and antipsychotics or antidepressants.

Summary: Oncology patients are often required to deal with chemotherapy-induced nausea and vomiting at the same time as psychosocial distress. A review of primary literature, as well as several drug interaction databases, was performed with anti-emetics used in The NCCN® 1.2010 Anti-emesis Guidelines (n = 11) and all currently US-marketed antidepressants or antipsychotics (n = 40).(1) The results from these databases were compiled into a single easy-to-use chart that portrays the severity of the interaction and brief recommendation.(2,3,4) In total, 197 drug-drug interactions out of a total of 440 possible combinations (44.8%) were discovered during the analysis.

Conclusions: Although most anti-emetics had several serious interactions with antidepressants or antipsychotics, palonosetron, and granisetron were found to have no significant interactions. The results can be used to avoid or limit drug interactions in the prescribing of new medications for the oncology patient.(1,2,3,4).

Publication types

  • Review

MeSH terms

  • Animals
  • Antidepressive Agents / metabolism
  • Antidepressive Agents / therapeutic use
  • Antiemetics / metabolism
  • Antiemetics / therapeutic use
  • Antineoplastic Agents / metabolism
  • Antineoplastic Agents / therapeutic use
  • Antipsychotic Agents / metabolism
  • Antipsychotic Agents / therapeutic use
  • Drug Interactions* / physiology
  • Humans
  • Nausea / drug therapy*
  • Nausea / metabolism
  • Neoplasms / drug therapy*
  • Neoplasms / epidemiology
  • Neoplasms / metabolism
  • Stress, Psychological / drug therapy*
  • Stress, Psychological / metabolism
  • Treatment Outcome

Substances

  • Antidepressive Agents
  • Antiemetics
  • Antineoplastic Agents
  • Antipsychotic Agents