Caro-Teller JM, Cortijo-Cascajares S, Escribano-Valenciano I, Campo-Angora M, Ferrari-Piquero JM
Servicio de Farmacia. Hospital Universitario 12 de Octubre. Madrid (España)
Rev. OFIL 2016, 26;2:117-122
Fecha de recepción: 08/06/2015 – Fecha de aceptación: 03/01/2016
Objective: To identify, describe and establish therapeutic recommendations for the pharmacologic interactions between abiraterone and concomitant medication of patients with metastatic prostate cancer.
Material and method: A retrospective observational study was carried out including all patients treated with abiraterone during 2014. Age and concomitant medication were the variables recorded. The interactions were identified using the Lexi-InteractTM software tool and they were classified into three categories (minor, moderate and major) according to their clinical relevance. The mechanism of action of each interaction was analyzed and the drugs which were more involved were determined determined. The following general recommendations were established: to monitor treatment (for minor interactions), to consider therapeutic substitution (for moderate) and to avoid association (for major).
Results: A total of 38 patients were included. The median number of drugs administered concomitantly was 10 (range: 2-17). 90 interactions with abiraterone were recorded of 43 different drugs. The 81.58% of patients had at least one potential interaction. The median of interactions per patient was 2 (range: 0-6). The distribution of interactions based on their relevance were 65 minor (72.22%), 22 moderate (24.44%) and 3 major (3.34%). The inhibitions of multiple metabolic pathways as CYP3A4 (28.6%), CYP2D6 (16.7%), CYP2C9 (11.9%) and P-glycoprotein (21.4%) by abiraterone was the main mechanism of action.
Conclusions: The majority of patients had at least one potential interaction between their home treatment and abiraterone. The interactions analyzed were mainly due to the inhibitory effect of abiraterone on multiple metabolic pathways.
Key Words: Abiraterone, prostate, interaction.
José Manuel Caro-Teller
C/ Uruguay, 8 – 10º D
28822 Coslada (Madrid)
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