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Table 2 Most occurring potential drug-drug interaction for each level of severity

From: Prevalence and nature of potential drug-drug interactions among hospitalized HIV patients presenting with suspected meningitis in Uganda

Severitya Drug 1 Drug 2 % pDDI overallb Level of evidencec Proposed effect summary
Contraindicated
  Fluconazole Ondansetron 3.6 Fair Risk of QT interval prolongation
  Fluconazole Haloperidol 2.8 Fair Increased haloperidol exposure, risk of QT interval prolongation
  Fluconazole Ritonavir 1.1 Fair Increased ritonavir exposure, risk of QT interval prolongation
  Artane Potassium (oral) 0.8 Fair Gastrointestinal lesions
  Fluconazole Atazanavir 0.8 Fair Increased atazanavir exposure, risk of QT interval prolongation
  Fluconazole Artemether- lumefantrine 0.7 Fair Risk of QT interval prolongation
  Dihydroartemisinin-piperaquine Efavirenz 0.2 Fair Risk of QT interval prolongation
  Fluconazole Dihydroartemisinin-piperaquine 0.2 Fair Risk of QT interval prolongation
  Haloperidol Metoclopramide 0.2 Fair Increased extrapyramidal reactions and neuroleptic malignant syndrome
  Fluconazole Quinine 0.1 Fair Increased quinine levels, risk of QT interval prolongation
Major
  Co-trimoxazole Fluconazole 18 Fair Cardiotoxicity (QT prolongation, torsades)
  Efavirenz Fluconazole 8.6 Fair Risk of QT interval prolongation
  Codeine Fluconazole 4.8 Fair Increased codeine concentration
  Isoniazid Rifampin 4.5 Good Hepatotoxicity
  Co-trimoxazole Haloperidol 2.4 Fair Cardiotoxicity (QT prolongation, torsades)
  Pyrazinamide Rifampin 2.4 Good Hepatotoxicity
  Fluconazole Metronidazole 2.3 Fair Risk of QT interval prolongation and arrhythmias
  Efavirenz Ondansetron 1.3 Fair QT interval prolongation
  Codeine Efavirenz 1.1 Fair Decreased codeine efficacy
  Codeine Metoclopramide 1.1 Fair Increased CNS depression
  Azithromycin Fluconazole 1.1 Fair Risk of QT interval prolongation
  Ciprofloxacin Fluconazole 1.1 Fair Risk of QT interval prolongation
  Fluconazole Tramadol 0.9 Fair Increased tramadol exposure and increased risk of respiratory depression
  Acetaminophen Isoniazid 0.9 Excellent Hepatotoxicity
  Efavirenz Rifampin 0.9 Fair Decreased serum efavirenz concentration
Moderate
  Fluconazole Zidovudine 4.2 Good Increased zidovudine serum concentration
  Fluconazole Rifampin 2.2 Excellent Decreased fluconazole serum concentration
  Artane Haloperidol 1.2 Good Excessive anticholinergic effects
  Acetaminophen Zidovudine 0.9 Good Hepatotoxicity (acetaminophen driven)
Minor
  Co-trimoxazole Zidovudine 3.6 Good Increased zidovudine serum concentration
  1. a Severity classification for clinical purposes per IBM Micromedex DRUGDEX® database definitions
  2. b Percent of overall pDDI for study, % reported as (n/ 4582 total pDDI events) * 100
  3. c Strength of scientific data for the interaction per IBM Micromedex DRUGDEX® database; (i) excellent – clearly documented well controlled studies support the interaction; (ii) good – studies strongly suggest that interaction exists however there are not well controlled studies; (iii) fair – available evidence is poor but clinicians suspect the interaction exists based on pharmacology or the available evidence is good for a pharmacologically similar drug; and (iv) unknown – interaction documentation is unknown
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BMC Infectious Diseases

ISSN: 1471-2334

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