DETECTING DRUG-DRUG INTERACTIONS INDUCED BY ANTACIDS ENCOUNTERED IN A COMMUNITY PHARMACY: AN OBSERVATIONAL STUDY

Year 2024, Volume: 48 Issue: 2, 479 - 485, 20.05.2024

Didem Gökeş Miray Arslan

https://doi.org/10.33483/jfpau.1432068

Abstract

Objective: This study aimed to reveal drug-drug interactions (DDIs) due to antacids through programs used to detect DDIs.
Material and Method: Within the scope of this study, 207 prescriptions containing at least one antacid and a drug from a different pharmacological group were evaluated in terms of DDIs. Evaluations were made on the prescriptions received in a community pharmacy serving in Van, Türkiye. Three different DDI checking programs were used for this evaluation.
Result and Discussion: Antacid-induced DDIs were detected in 64 of the prescriptions. Interactions occurred between 52 active ingredient pairs, and it was revealed that DDIs were most common between calcium carbonate and famotidine. This interaction is minor and has been detected by only one database. Another common interaction was found between the calcium carbonate and cholecalciferol (Vitamin D) pair, and this interaction was reported as Level 2 and should be closely monitored in two different databases. As a result, DDIs induced by antiacids generally were found to be at moderate levels. However, it is seen that three DDI checking programs used in the study provide different results in detecting DDIs.

Keywords

Antacids, community pharmacy, drug-drug interactions, observational study

Ethical Statement

This study was conducted after Van Yüzüncü Yıl University Non-interventional Research Ethics Committee approved the study ethically (Date:18/11/2022, Decision No: 2022/11-26).

Thanks

This study was created by expanding the graduation project that the first author completed at Van Yüzüncü Yıl University Faculty of Pharmacy under the supervision of the corresponding author. The authors would like to thank Pharm. Özge Ateş for helping with data gathering.

BİR TOPLUM ECZANESİNDE KARŞILAŞILAN ANTİASİTLER KAYNAKLI İLAÇ ETKİLEŞİMLERİNİN TESPİTİ: GÖZLEMSEL BİR ÇALIŞMA

Abstract

Amaç: Bu çalışma, ilaç-ilaç etkileşimlerini (DDIs) tespit etmek için kullanılan programlar aracılığıyla antiasitler nedeniyle oluşan DDI’leri tespit etmeyi amaçlamaktadır.
Gereç ve Yöntem: Bu çalışma kapsamında en az bir antiasit ve farklı farmakolojik gruptan bir ilaç içeren 207 reçete DDI açısından ele alınmıştır. Bu doğrultuda, Van'da hizmet veren bir toplum eczanesinde karşılanan reçeteler değerlendirilmiştir. Bu değerlendirmeler için üç farklı DDI kontrol programı kullanılmıştır.
Sonuç ve Tartışma: Reçetelerin 64'ünde antiasit kaynaklı DDI tespit edilmiştir. 52 aktif madde çifti arasında etkileşim meydana gelmiş olup, DDI'ların en yaygın olarak kalsiyum karbonat ve famotidin arasında olduğu ortaya konulmuştur. Bu etkileşimin minor düzeyde olup, yalnızca bir veritabanı tarafından tespit edilmiştir. Diğer bir sık karşılaşılan etkileşim ise kalsiyum karbonat ve kolekalsiferol (Vitamin D) çifti arasında bulunmuştur. Bu etkileşim Düzey 2 ve yakından takip edilmesi gerekir olacak şekilde iki farklı program tarafından tespit edilmiştir. Sonuç olarak antiasitlerin neden olduğu DDI'ların genel olarak orta düzeyde ciddiyete sahip olduğu bulunmuştur. Ancak çalışmada kullanılan üç DDI kontrol programının DDI'ların tespitinde farklı sonuçlar verdiği görülmüştür.

Keywords

Antasitler, gözlemsel çalışma, ilaç-ilaç etkileşimleri, toplum eczanesi

References

• 1. Jagadesh, K., Chidananda, K.N. (2015). Study of acid neutralizing capacity of various antacid formulations. Asian Journal of Pharmaceutical Technology and Innovation, 3(12), 1-6.
• 2. Pegu, K.D. (2020). Pharmacology of antacids. Southern African Journal of Anaesthesia and Analgesia, 26(6), 133-136.
• 3. Maton, P.N., Burton, M.E. (1999). Antacids revisited: A review of their clinical pharmacology and recommended therapeutic use. Drugs, 57, 855-870.
• 4. Tomina, O.E., Yabluchansky, M.I., Bychkova, O.Y., Ivleva, O.O. (2014). Antacids clinical pharmacology. Вестник Харьковского национального университета имени ВН Каразина. Серия «Медицина», (28), 52-57.
• 5. ur Rehman, I., Khan, Q., Sharif, M.J.H., Bashir, H., Iqbal, M., Amirzada, M.I. (2023). Potential drug-drug interactions in patients presenting with osteoarthritis to community orthopaedic clinics of Abbottabad, Khyber Pakhtunkhwa: a cross-sectional study. Annales Pharmaceutiques Françaises, 81(5), 856-862. [CrossRef]
• 6. Sadowski, D.C. (1994). Drug interactions with antacids: Mechanisms and clinical significance. Drug Safety, 11(6), 395-407.
• 7. Gugler, R., Allgayer, H. (1990). Effects of antacids on the clinical pharmacokinetics of drugs: an update. Clinical Pharmacokinetics, 18, 210-219. [CrossRef]
• 8. Ünlü, B. (2019). Specialty Thesis. Edirne kent merkezinde gastoözofageal reflü hastalığı semptom prevalansı. Faculty of Pharmacy, Trakya University, Trakya, Ankara.
• 9. Ogawa, R., Echizen, H. (2011). Clinically significant drug interactions with antacids: An update. Drugs, 71, 1839-1864.
• 10. Muhič, N., Mrhar, A., Brvar, M. (2017). Comparative analysis of three drug-drug interaction screening systems against probable clinically relevant drug-drug interactions: a prospective cohort study. European Journal of Clinical Pharmacology, 73, 875-882. [CrossRef]
• 11. Aykut, B., Arslan, M. (2023). An observational study on drug interactions caused by proton pump inhibitors. European Journal of Life Sciences, 2(1), 25-30. [CrossRef]
• 12. Fritz, K., Taylor, K., Parmar, M. (2023). Calcium Carbonate. In: StatPearls [Internet]. Treasure Island (FL): Stat Pearls Publishing; PMID: 32965974.
• 13. Zhai, Q., Fu, J., Huang, X., Xu, B., Yuan, Y.Z., Jiang, T., Rong, Z.X., Chen, H.Z. (2008). Clinical study on the influence of a fixed-dose combination of famotidine with calcium carbonate and magnesium hydroxide on the bioavailability of famotidine. Arzneimittelforschung, 58(11), 581-584. [CrossRef]
• 14. Singh, N., Weisler, S.L., Hershman, J.M. (2001). The acute effect of calcium carbonate on the intestinal absorption of levothyroxine. Thyroid, 11(10), 967-971. [CrossRef]
• 15. Skelin, M., Lucijanić, T., Klarić, D.A., Rešić, A., Bakula, M., Liberati-Čizmek, A.M., Gharib, H., Rahelić, D. (2017). Factors affecting gastrointestinal absorption of levothyroxine: A review. Clinical Therapeutics, 39(2), 378-403. [CrossRef]
• 16. Arslan, A.Y., Ardıç, C., Uzun, K., Karakullukçu, S. (2021). Evaluation of the correct use of levothyroxine in patients with hypothyroidism. The Journal of Turkish Family Physician, 12(2), 57-65. [CrossRef]
• 17. Goel, A., Shivaprasad, C., Kolly, A., Pulikkal, A.A., Boppana, R., Dwarakanath, C.S. (2017). Frequent occurrence of faulty practices, misconceptions and lack of knowledge among hypothyroid patients. Journal of Clinical and Diagnostic Research, 11(7), OC15. [CrossRef]
• 18. Al-Ramahi, R., Raddad, A.R., Rashed, A.O., Bsharat, A., Abu-Ghazaleh, D., Yasin, E., Shehab, O. (2016). Evaluation of potential drug-drug interactions among Palestinian hemodialysis patients. BMC nephrology, 17, 1-6. [CrossRef]
• 19. Frost, R.W., Lasseter, K.C., Noe, A.J., Shamblen, E.C., Lettieri, J.T. (1992). Effects of aluminum hydroxide and calcium carbonate antacids on the bioavailability of ciprofloxacin. Antimicrobial Agents and Chemotherapy, 36(4), 830-832. [CrossRef]
• 20. Arayne, M.S., Sultana, N., Hussain, F. (2005). Interactions between ciprofloxacin and antacids-dissolution and adsorption studies. Drug Metabolism and Drug Interactions, 21(2), 117-130. [CrossRef]