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Beneficial Pharmacokinetic Drug Interactions | OMICS International | Abstract
ISSN: 2167-1052

Advances in Pharmacoepidemiology and Drug Safety
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Review Article

Beneficial Pharmacokinetic Drug Interactions

David J. Edwards*
School of Pharmacy, University of Waterloo 200 University Avenue West, Waterloo, Ontario, Canada N2L 3G1, USA
*Corresponding Author : David J. Edwards, PharmD, MPH
Hallman Director and Professor
School of Pharmacy, University of Waterloo
200 University Avenue West, Waterloo, Ontario
Canada N2L 3G1, USA
Tel: 519-888-4408
Fax: 519-883-7580
E-mail: [email protected]
Received September 06, 2012; Accepted October 19, 2012; Published October 21, 2012
Citation: Edwards DJ (2012) Beneficial Pharmacokinetic Drug Interactions. Adv Pharmacoepidem Drug Safety S1:002. doi:10.4172/2167-1052.S1-002
Copyright: © 2012 Edwards DJ. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Pharmacokinetic drug interactions are common, particularly in elderly patients taking multiple medications, and are generally unexpected with negative consequences for the patient. However, there are a number of reasons why clinicians may wish to strategically employ a combination of drugs to optimize response to treatment. Inhibitors of cytochrome P450-mediated drug metabolism in the liver and intestinal wall can improve oral bioavailability, reduce clearance and prolong half-life of co-administered therapeutic agents such as immunosuppressant’s and protease inhibitors. Potential benefits include reduced daily dose and cost of therapy, less variability in plasma concentrations and longer dosing intervals for patient convenience and compliance. Inducers of metabolism such as phenytoin or St. John’s wort may be of value when given with drugs whose effects are primarily mediated by active metabolites. Finally, inhibitors of the activity of drug transport proteins such as p-glycoprotein can have a similar effect as inhibitors of drug metabolism on the pharmacokinetic properties of co-administered drugs. In addition, uptake of drug into cancer cells or tissues such as the central nervous system may be disproportionately increased resulting in more effective treatment. This paper provides an overview of the theoretical rationale for beneficial drug interactions with specific examples of interactions that are currently being used clinically or actively undergoing research.

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