POTENTIAL AND CLINICALLY SIGNIFICANT CYP3A4 MEDIATED DRUG INTERACTIONS IN HOSPITALIZED PATIENTS: A CROSS-SECTIONAL OBSERVATIONAL STUDY

Abstract

Background: Drug interactions occur due to the simultaneous administration of pharmacological agents that affect the efficacy of concomitant drugs. Objective: Estimate the prevalence of CYP3A4 enzyme-mediated drug interactions in a tertiary care hospital along with a focus on clinical significance. Materials and Methods: An observational cross-sectional study was conducted over three months. A total of 180 patients with polypharmacy and two or more CYP3A4-mediated drugs in the prescription were included. Data collected from patient case sheets and drug-drug interactions were analyzed using Micromedex, SuperCYP database, and literature along with consideration of personal habits (smoking and alcohol). Results: Among 180 patients, 132 CYP3A4-mediated drug interactions were noted. The prevalence of CYP3A4 interactions was 50.56%, with 40.56% being drug-drug interactions, 10.5% drug-alcohol interactions, and 1.66% food-drug interactions. The most common combination of interacting drugs and clinical factors associated with interacting drugs were reported. Clinically significant interactions were observed in 13 patients. Conclusion: We estimated the prevalence of CYP3A4 enzyme-mediated drug interactions both potential and clinically significant, and reported accordingly. The prescriber’s understanding of CYP3A4-associated drug-drug interactions and the recognition of resultant consequences constitutes the primary approach for reducing patient distress, by timely interventions.