Assessment of non-linear combination effect terms for drug-drug interactions

J Pharmacokinet Pharmacodyn. 2016 Oct;43(5):461-79. doi: 10.1007/s10928-016-9490-0. Epub 2016 Sep 16.

Abstract

Drugs interact with their targets in different ways. A diversity of modeling approaches exists to describe the combination effects of two drugs. We investigate several combination effect terms (CET) regarding their underlying mechanism based on drug-receptor binding kinetics, empirical and statistical summation principles and indirect response models. A list with properties is provided and the interrelationship of the CETs is analyzed. A method is presented to calculate the optimal drug concentration pair to produce the half-maximal combination effect. This work provides a comprehensive overview of typically applied CETs and should shed light into the question as to which CET is appropriate for application in pharmacokinetic/pharmacodynamic models to describe a specific drug-drug interaction mechanism.

Keywords: Bliss Independence; Combination therapy; Drug–drug interaction; Loewe Additivity; Optimal concentration.

Publication types

  • Review
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Computer Simulation
  • Dose-Response Relationship, Drug
  • Drug Interactions*
  • Drug Therapy, Combination
  • Humans
  • Kinetics
  • Models, Biological*
  • Nonlinear Dynamics
  • Pharmaceutical Preparations / administration & dosage
  • Pharmaceutical Preparations / metabolism
  • Pharmacokinetics*
  • Protein Binding
  • Receptors, Drug / metabolism

Substances

  • Pharmaceutical Preparations
  • Receptors, Drug