Original Article

Evaluation of Drug Interactions in Hospitalized Patients with Malignancy


Background: Drug-drug interaction (DDI) occurs when the pharmacological effect of a drug is altered due to concomitant administration with other drugs. DDIs still remain a serious issue; thus, we conducted this retrospective study to evaluate DDIs prevalence in our care center.

Methods: All admitted patients with any kind of malignancies that received at least two medications from oncology and non-oncology classifications during six months were enrolled in this study. All relevant data including, patients’ demographic information, diagnosis, hospitalization duration, and all administered medication during hospitalization were recorded. The DDI was assessed by using the latest version of Lexi-interact.

Results: Each patient received a mean number of 11.6±4.7 medications. The number of non-oncology drugs demonstrated a remarkable correlation with the number of interactions (P<0.001).

Whereas, the number of oncology drugs does not have any relation with the number of interactions (P=0.64). Among the 763 detected DDIs during this study, the incidence of major, moderate and minor interactions were 31.2%, 61.4%, and 7.3%, respectively.

Conclusion: Our results highlighted the clinical significance of DDIs, considering that 104 (92%) patients had at least one DDI. The main reason that could have potentially contributed to this outcome is the complicated nature of cancer treatment and clinical management. We believe that using computer software to collect all prescribed and OTC collaboration of clinical pharmacists with oncologists can reduce the potential interactions prior to drug administration.

1. Scripture C, Figg W. Drug interactions in cancer therapy. Nat Rev Cancer. 2006; 6(7):546–58.
2. Beijnen JH, Schellens JH. Drug interactions in oncology. Lancet Oncol. 2004;5(8):489-96.
3. Miranda V, Fede A, Nobuo M, et al. Adverse drug reactions and drug interactions as causes of hospital admission in oncology. J Pain Symptom Manage. 2011;42(3):342-53.
4. Ferlay J, Ervik M, Lam F, et al. Global Cancer Observatory: Cancer Today. Lyon: International Agency for Research on Cancer; 2020 (https://gco.iarc.fr/today, accessed February 2021).
5. van Leeuwen RW, Swart EL, Boven E, et al. Potential drug interactions in cancer therapy: a prevalence study using an advanced screening method. Ann Oncol. 2011;22(10):2334-41.
6. Ussai S, Petelin R, Giordano A, et al. A pilot study on the impact of known drug-drug interactions in cancer patients. J Exp Clin Cancer Res. 2015;34(1):89.
7. Verschraagen M, Kedde MA, Hausheer FH, et al. The chemical reactivity of BNP7787 and its metabolite mesna with the cytostatic agent cisplatin: comparison with the nucleophiles thiosulfate, DDTC, glutathione and its disulfide GSSG. Cancer Chemother Pharmaco.2003; 51(6): 499–504.
8. Scripture CD, Figg WD. Drug interactions in cancer therapy. Nat Rev Cancer. 2006;6(7):546-58.
9. van Leeuwen RW, Brundel DH, Neef C, et al. Prevalence of potential drug-drug interactions in cancer patients treated with oral anticancer drugs. Br J Cancer. 2013;108(5):1071-8.
10. Reis AM, Cassiani SH. Evaluation of three brands of drug interaction software for use in intensive care units. Pharm World Sci. 2010;32(6):822-8.
11. Vonbach P, Dubied A, Krähenbühl S, et al. Evaluation of frequently used drug interaction screening programs. Pharm World Sci. 2008;30(4):367-74.
12. Herrstedt J, Dombernowsky P. Anti-emetic therapy in cancer chemotherapy: current status. Basic Clin Pharmacol Toxicol. 2007;101(3):143-50.
13. Blower P, de Wit R, Goodin S, et al. Drug-drug interactions in oncology: why are they important and can they be minimized? Crit Rev Oncol Hematol. 2005;55(2):117-42.
14. Mohammadzadeh M, Hatefi S, Reshadi N, et al. Assessment of the Adherence Rate of Acute Chemotherapy Induced Nausea and Vomiting Prophylaxis Regimens by Medical Team to NCCN Clinical Recommendations: Cross-Section Observation. J Pharm Care. 9(1):24-30.
15. Woosley RL, Heise CW, Romero KA. www.Crediblemeds.org, QTdrugs List, Accession Date, AZCERT, Inc. 1822 Innovation Park Dr., Oro Valley, AZ 85755
16. Roden DM. A current understanding of drug-induced QT prolongation and its implications for anticancer therapy. Cardiovasc Res. 2019;115(5):895-903.
IssueVol 16, No 4 (2022) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/ijhoscr.v16i4.10880
Drug-drug interaction; Over-the-counter (OTC) drugs; Malignancy; Oncology

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How to Cite
Hatefi S, Kadkhodaei A, Nejati B, Ghaffary S. Evaluation of Drug Interactions in Hospitalized Patients with Malignancy. Int J Hematol Oncol Stem Cell Res. 2022;16(4):224-230.