Conceptual and Practical Update on Drug-Drug Interactions

Recently, the topic of Drug-Drug interactions has received a better attention from the regulatory, scientific, and healthcare community worldwide. Although it is impossible to present all the drug combination causing Drug-Drug Interactions (DDIs), this article will summarize the mechanism of action associated with DDIs. DDIs tends to be more common among certain patients with underlying diseases, co-morbid conditions, etc., and in specific clinical situations such as polypharmacy and usage of drugs with a narrow therapeutic range or low therapeutic index. Therefore, successful prevention requires knowledge on molecular mechanisms of drug interaction, severity classification, management and prevention of drug interaction and sources of information on drug interaction, coupled with vigilance, reporting of drug interaction and early intervention. Surprisingly, little information is available to guide us with respect to avoiding complications in critical situation. Therefore, it is necessary to focus more on the concept of drug interaction. Software checkers for identifying drug interactions are widely available. Since the sorting out of clinically significant drug interaction is impossible with these software's, it has limited clinical utility. As it is no longer practical for physicians to memorize the list of drug interactions to avoid potential drug interactions, it is an important part of clinical practice of knowing how drugdrug interactions occur and how to manage them. Hence, this review aims to present the conceptual framework of drug-drug interactions and their path physiology.