[The clinical relevance of drug interactions in patients with human immunodeficiency virus infection: update 2015-2017]. / Relevancia clínica de las interacciones medicamentosas en pacientes infectados con el virus de la inmunodeficiencia humana: actualización 2015-2017.

BACKGROUND: The pharmacokinetics of anti-retrovirals (ARVs) can be modified by other concomitant medicinal products. It is timely to update the interactions between new ARVs and drugs of chronic use to maintain therapeutic success. AIM: To update information about drug interactions in patients with HIV/AIDS on antiretroviral therapy. METHODS: Comprehensive literature review in MEDLINE/PubMed database from January of 2015 to June of 2017, using the Mesh terms: Anti-retroviral agents and drug interactions or herb-drug interactions or food-drug interactions. Publications with drug interactions in humans, in English or Spanish, and with full text were retrieved. Additionally, citation lists from identified articles were reviewed. The study inclusion was assessed by three independent researchers and by consensus among them when was necessary. Clinical relevance of drug interaction was grouped into levels according to seriously and probability of occurrence. RESULTS: 466 articles were identified; full text was accessed in 444. Of these, 164 provided interactions, which allowed the identification of a total of 534 pairs of drug interactions. The interactions that presented a higher risk of generating safety and effectiveness problems were 308 (57.7%) of level 2 and 35 (6.6%) of level 1. CONCLUSIONS: We identify 534 new pairs of drug interactions, of which 308 (64.2%) are the most clinically relevant.

Relevancia clínica de las interacciones medicamentosas en pacientes infectados con el virus de la inmunodeficiencia humana: actualización 2015-2017 / The clinical relevance of drug interactions in patients with human immunodeficiency virus infection: update 2015-2017

Resumen Introducción: La farmacocinética de los anti-retrovirales (ARVs) puede ser modificada por otros medicamentos de uso concomitante. Es oportuno actualizar las interacciones entre nuevos ARVs y fármacos de uso crónico para mantener un éxito terapéutico. Objetivo: Actualizar información sobre interacciones medicamentosas en pacientes con infección por VIH/SIDA en terapia antiretroviral. Método: Revisión estructurada en MEDLINE/ PubMed utilizando los términos Mesh: Anti-retroviral agents and drug interactions or herb-drug interactions or food-drug interactions, entre enero de 2015 y junio de 2017. Fueron seleccionadas publicaciones sobre interacciones medicamentosas en humanos, en inglés o español y con acceso a texto completo. Además, se incluyeron referencias de artículos considerados relevantes. La inclusión de los artículos fue evaluada por tres investigadores independientes y, en caso de requerirlo, por consenso entre ellos. La relevancia clínica se estableció, acorde con la gravedad y probabilidad de ocurrencia de la interacción. Resultados: Se identificaron 466 artículos, se accedió a texto completo a 444. De éstos, 164 aportaron interacciones, lo que permitió identificar un total de 534 parejas de interacciones medicamentosas. Las interacciones que presentaron un mayor riesgo de generar problemas de seguridad y efectividad fueron 308 (57,7%) de nivel 2 y 35 (6,6%) de nivel 1. Conclusiones: Se identifican 534 parejas nuevas de interacciones medicamentosas, de ellas 308 (64,2%) de mayor relevancia clínica.

Background: The pharmacokinetics of anti-retrovirals (ARVs) can be modified by other concomitant medicinal products. It is timely to update the interactions between new ARVs and drugs of chronic use to maintain therapeutic success. Aim: To update information about drug interactions in patients with HIV/AIDS on antiretroviral therapy. Methods: Comprehensive literature review in MEDLINE/PubMed database from January of 2015 to June of 2017, using the Mesh terms: Anti-retroviral agents and drug interactions or herb-drug interactions or food-drug interactions. Publications with drug interactions in humans, in English or Spanish, and with full text were retrieved. Additionally, citation lists from identified articles were reviewed. The study inclusion was assessed by three independent researchers and by consensus among them when was necessary. Clinical relevance of drug interaction was grouped into levels according to seriously and probability of occurrence. Results: 466 articles were identified; full text was accessed in 444. Of these, 164 provided interactions, which allowed the identification of a total of 534 pairs of drug interactions. The interactions that presented a higher risk of generating safety and effectiveness problems were 308 (57.7%) of level 2 and 35 (6.6%) of level 1. Conclusions: We identify 534 new pairs of drug interactions, of which 308 (64.2%) are the most clinically relevant.

Respuesta: Relevancia clínica de las interacciones medicamentosas / Reply: Clinical significance of drug interactions

No disponible

[Clinical relevance of drug interactions]. / Interacciones medicamentosas: aproximación para establecer y evaluar su relevancia clínica.

The identification, prevention, and solution of drug interactions are a critical aspect to achieved desired pharmacotherapy goals. The purpose of this review was to organize information about drug interactions, and to develop an approach to identify and evaluate drug interactions considered clinically relevant. Data for this review were identified by search of MEDLINE and PubMed and references cited in relevant articles. <> plus <>, <> or <> were searched in titles or in abstracts. Only papers published in English and Spanish from January of 1996 to June of 2006 and in humans were reviewed. We reviewed the type and mechanism of drug interactions, and we highlight those associated to changes in the systemic clearance or in the bioavailability. So, we provide an approach to evaluate and use the clinical relevance of drug interactions complemented with a classification based on the severity and probability of its occurrence.

Interacciones medicamentosas: aproximación para establecer y evaluar su relevancia clínica / Clinical relevance of drug interactions

La identificación, prevención y tratamiento de las interacciones medicamentosas clínicamente relevantes son aspectos fundamentales en la farmacoterapia. En este trabajo se ha pretendido sistematizar la información y desarrollar una propuesta para establecer y evaluar la relevancia clínica de las interacciones medicamentosas. Se realizó una revisión bibliográfica en Medline y PubMed, y en las referencias de los artículos considerados relevantes. En los títulos y resúmenes de los artículos se buscó el término «interacciones medicamentosas» combinado con «relevante clínicamente», «relevancia clínica» o «relevante significativamente». Se incluyeron las publicaciones realizadas en humanos, en inglés o español, entre enero de 1996 y junio de 2006. Se presentan el tipo y mecanismo de las interacciones medicamentosas, especialmente las asociadas a cambios en el aclaramiento sistémico y en la biodisponibilidad; se propone una secuencia de pasos a seguir para establecer la relevancia clínica de las interacciones y una clasificación basada en la gravedad y probabilidad de aparición

The identification, prevention, and solution of drug interactions are a critical aspect to achieved desired pharmacotherapy goals. The purpose of this review was to organize information about drug interactions, and to develop an approach to identify and evaluate drug interactions considered clinically relevant. Data for this review were identified by search of MEDLINE and PubMed and references cited in relevant articles. «Drug interactions» plus «clinical relevance», «clinically relevant» or «significantly relevant» were searched in titles or in abstracts. Only papers published in English and Spanish from January of 1996 to June of 2006 and in humans were reviewed. We reviewed the type and mechanism of drug interactions, and we highlight those associated to changes in the systemic clearance or in the bioavailability. So, we provide an approach to evaluate and use the clinical relevance of drug interactions complemented with a classification based on the severity and probability of its occurrence