Outcomes of Drug Interactions Between Antiretrovirals and Co-Medications, Including Over-the-Counter Drugs: A Real-World Study.


Ambrosioni, Juan ORCID: 0000-0001-9931-6686, Díaz, Natalia Anahí, Marzolini, Catia ORCID: 0000-0002-2312-7050, Dragovic, Gordana, Imaz, Arkaitz, Calcagno, Andrea, Luque, Sonia, Curran, Adrian, Troya, Jesus, Tuset, Montse et al (show 5 more authors) (2024) Outcomes of Drug Interactions Between Antiretrovirals and Co-Medications, Including Over-the-Counter Drugs: A Real-World Study. Infectious diseases and therapy, 13 (3). pp. 609-617.

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Abstract

<h4>Introduction</h4>The objective was to characterize real-world outcomes of drug-drug interactions (DDIs) between antiretrovirals (ARVs) and other drugs, including over-the-counter medications (OTC), and treatment outcomes in clinical practice.<h4>Methods</h4>www.clinicalcasesDDIs.com is an open-access website for healthcare providers to consult and briefly describe real-world clinical cases on DDI with ARVs. We reviewed all the clinical cases reported to the website between March 2019 and May 2023.<h4>Results</h4>A total of 139 cases were reported, mostly involving ritonavir or cobicistat (boosters; 74 cases), unboosted integrase inhibitors (InSTI; 29 cases), and non-nucleoside reverse transcriptase inhibitors (NNRTI; 23 cases). Central nervous system drugs (29 cases) and cardiovascular drugs (19 cases) were the most frequently described co-medications. Notably, OTC medications were implicated in 27 cases, including mineral supplements (11 cases), herbals (8 cases), weight loss drugs (4 cases), anabolic steroids (3 cases), and recreational drugs (1 case). OTC acted as the perpetrator drug in 21 cases, leading to loss of ARV efficacy in 17 instances (mineral supplements in 10 cases, weight loss drugs in 4 cases, herbals in 3 cases). Additionally, toxicity was reported in 4 out of 6 cases where OTC was considered the victim drug of the DDI (anabolic steroids in 3 cases, MDMA in 1 case).<h4>Conclusions</h4>Frequent unwanted outcomes resulting from DDIs between ARVs and OTC medications underscore the importance of integrating non-prescription drugs into medication reconciliation. The real-world data available through www.clinicalcasesDDIs.com serves as a valuable resource for assessing the clinical relevance of DDIs.

Item Type: Article
Uncontrolled Keywords: Drug interactions, HIV infection, Over-the-counter medications, Real-life clinical cases
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology
Depositing User: Symplectic Admin
Date Deposited: 23 Apr 2024 08:51
Last Modified: 23 Apr 2024 08:52
DOI: 10.1007/s40121-024-00935-0
Open Access URL: https://doi.org/10.1007/s40121-024-00935-0
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3180528
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