Drug Interactions of Dihydropyridine Calcium Channel Blockers (CCBs):

https://www.researchgate.net/publication/338689291_Drug_Interactions_of_Dihydropyridine_Calcium_Channel_Blockers_CCBs_involving_CYP3A4_Enzymes

http://ejournal5.com/journals_n/1579189350.pdf

   §    Dihydropyridine Calcium Channel Blockers (CCBs) are widely used as first-line agents to treat hypertension in black patients and in patients aged more than 55 years.

   §    First-generation DHPs include

Ø Nifedipine

Ø Nicardipine,

   §    Second-generation DHPs include

Ø Benidipine

Ø Efonidipine

   §    Third-generation DHPs include

Ø Amlodipine

Ø Azelnidipine

   §    Fourth-generation drugs include

Ø Lercanidipine

Ø Lacidipine

   §    The dihydropyridine CCBs are approved to manage the patients with hypertension and angina

   §    Dihydropyridine CCBs interact with following drugs as Object drugs

·      Drugs increasing the plasma concentrations of dihydropyridine CCBs resulting in enhanced adverse effects

Ø Macrolide antibiotics

Ø Azole antifungals

Ø Protease inhibitors

Ø Grapefruit juice

Ø Seville orange juice

·      Drugs decreasing the plasma concentrations of dihydropyridine CCBs resulting in decreased bioavailability

Ø Rifampicin

Ø Phenytoin

Ø Carbamazepine

Ø Phenobarbital

   §    Dihydropyridine CCBs interact with following drugs as precipitant drugs

Ø Statins

Ø Cyclosporine

Ø Clopidogrel

   §    The prescribers and pharmacists are required to be aware of the adverse drug interactions of dihydropyridine CCBs to prevent adverse outcomes

   §    Healthcare professionals through the screening, education, and follow up on suspected drug interactions could reduce the risk of adverse effects.

   §    The patients are encouraged to ask their doctor or pharmacist to look over their list for any potentially dangerous combinations.

   §    It is recommended that people fill all their prescriptions at one pharmacy, if possible.

https://www.researchgate.net/publication/338689291_Drug_Interactions_of_Dihydropyridine_Calcium_Channel_Blockers_CCBs_involving_CYP3A4_Enzymes

http://ejournal5.com/journals_n/1579189350.pdf

Drug Interactions of SGLT2 Inhibitors (Gliflozins)

https://www.researchgate.net/publication/336995220_Drug_Interactions_of_SGLT2_Inhibitors_Gliflozins_involving_UGT_Enzymes

https://www.sryahwapublications.com/archives-of-diabetes-and-endocrine-system/pdf/v2-i2/3.pdf

   §    Sodium glucose cotransporter 2 (SGLT2) inhibitors are antidiabetic drugs.

   §    SGLT2 inhibitors include Canagliflozin, Dapagliflozin, Empagliflozin, Ertugliflozin and other Gliflozins.

   §    SGLT2 inhibitors prevent the reabsorption of glucose and facilitate its excretion through urine by inhibiting Sodium-glucose co-transporter-2 in the proximal convoluted tubule, which results in decrease in blood sugar.

   §    SGLT2 inhibitors such as Dapagliflozin, Canagliflozin and Ipragliflozin are metabolised by glucuronidation predominantly by UGT1A9 enzyme.

   §    The drugs inhibiting UGT1A9 such as Mefenamic acid and Probenecid slightly increased the plasma exposure of Dapagliflozin and Canagliflozin respectively.

   §    Rifampicin and other UGT inducers such as Phenytoin, Phenobarbital and Ritonavir were observed to decrease the plasma levels of Canagliflozin, insignificantly.

   §    The pharmacokinetics parameters of Warfarin, Digoxin, Simvastatin, Valsartan, Oral contraceptives containing Ethinyl estradiol and Levonorgestrel and Thiazide diuretics (Hydrochlorothiazide) were not altered significantly by the concomitant administration of Canagliflozin or Dapagliflozin.

   §    Coadministration of SGLT2 inhibitors such as Canagliflozin, Dapagliflozin and Ipragliflozin with other oral antidiabetic drugs did not result in any clinically significant interactions.

   §    SGLT2 inhibitors could be coadministered with any medicines without dosage adjustments except Canagliflozin which needs higher dosage while using along with UGT enzyme inducers. 

   §    Healthcare professionals through the screening, education, and follow up on suspected drug interactions could reduce the risk of adverse effects.

   §    The patients are encouraged to ask their doctor or pharmacist to look over their list for any potentially dangerous combinations.

   §    It is recommended that people fill all their prescriptions at one pharmacy, if possible.

https://www.researchgate.net/publication/336995220_Drug_Interactions_of_SGLT2_Inhibitors_Gliflozins_involving_UGT_Enzymes

https://www.sryahwapublications.com/archives-of-diabetes-and-endocrine-system/pdf/v2-i2/3.pdf

Drug Interactions of Alcohol:

https://www.researchgate.net/publication/336675683_Clinically_important_and_pharmacologically_relevant_drug_interactions_with_alcohol

https://www.ejmanager.com/mnstemps/146/146-1559448675.pdf?t=1571542833

   §    Alcohol is a psychoactive substance and its chronic use can lead to dependence.

   §    According to previous studies, about half of Alcohol users take medications interacting with Alcohol.

   §    Drugs Increasing Blood Alcohol Levels (BALs)

Ø H2 receptor blockers (Cimetidine or Ranitidine)

Ø Aspirin

Ø Metoclopramide

Ø Cisapride

Ø Erythromycin

   §    Drugs Increasing the risk of Disulfiram-like reactions

Ø Cephalosporins

Ø Metronidazole

Ø Sulphonamides

Ø Isoniazid

Ø Antifungals

Ø Sulfonylureas

   §    Drugs Increasing the risk of CNS depression

Ø Benzodiazepines

Ø Barbiturates

Ø Phenothiazines

Ø Opioid analgesics

Ø Antihistamines

   §    Drugs Increasing the risk of Hepatotoxicity

Ø Acetaminophen (Paracetamol)

   §    Drug increasing the risk of orthostatic hypotension

Ø Nitrates

   §    Drugs increasing the risk of UGIB

Ø NSAIDs

   §    Healthcare professionals through the screening, education, and follow up on suspected drug interactions could reduce the risk of adverse effects.

   §    The patients are encouraged to ask their doctor or pharmacist to look over their list for any potentially dangerous combinations.

   §    It is recommended that people fill all their prescriptions at one pharmacy, if possible.

https://www.researchgate.net/publication/336675683_Clinically_important_and_pharmacologically_relevant_drug_interactions_with_alcohol

http://www.ajrms.com/?mno=51492

https://www.ejmanager.com/mnstemps/146/146-1559448675.pdf?t=1571542833

Drug Interactions of Acetaminophen (Paracetamol) involving CYP and UGT Enzymes:

https://www.researchgate.net/publication/333618787_Drug_Interactions_of_Acetaminophen_Paracetamol_involving_CYP_and_UGT_Enzymes

http://ejournal5.com/journals_n/1558511353.pdf

   §    Acetaminophen (Paracetamol) is the most frequently used Over-The-Counter (OTC) antipyretic and analgesic drug, worldwide.

   §    The metabolism of Acetaminophen is mediated by phase II reactions (UDP-glucuronosyl transferases (UGT)-mediated glucuronidation and sulfation) and phase I oxidative reactions mediated by Cytochrome P450 (CYP) enzymes including CYP2E1 and CYP1A2.

   §    Drugs increasing the risk of acetaminophen-associated hepatotoxicity include

Ø Isoniazid

Ø Antiepileptic drugs (Carbamazepine, Phenytoin and Phenobarbital)

Ø Tyrosine kinase inhibitors (Imatinib, Sorafenib and Dasatinib)

Ø Alcohol

   §    Acetaminophen may increase the international normalized ratio (INR) by potentiating the anticoagulant effect of warfarin.

   §    Healthcare professionals through the screening, education, and follow up on suspected drug interactions could reduce the risk of adverse effects.

   §    The patients are encouraged to ask their doctor or pharmacist to look over their list for any potentially dangerous combinations.

   §    It is recommended that people fill all their prescriptions at one pharmacy, if possible.

https://www.researchgate.net/publication/333618787_Drug_Interactions_of_Acetaminophen_Paracetamol_involving_CYP_and_UGT_Enzymes

http://ejournal5.com/journals_n/1558511353.pdf

Drug Interactions of GLP-1 receptor agonists:

https://www.researchgate.net/publication/333746529_Pharmacologically_relevant_drug_interactions_of_Glucagon-like_peptide-1_receptor_agonists

 https://medcraveonline.com/JAPLR/JAPLR-08-00311.pdf

   §     Glucagon-like peptide-1 receptor agonists are incretin mimetics and they help to manage the blood glucose of patients with type 2 diabetes mellitus.

   §    The members of this class include Exenatide, Liraglutide, Lixisenatide, Albiglutide, Dulaglutide and Semaglutide.

   §     They are administered subcutaneously to manage fasting and postprandial blood glucose.

   §    GLP-1 receptor agonists may interact with

Ø Acetaminophen

Ø Digoxin

Ø Warfarin

Ø Oral contraceptive pills

Ø Metformin

Ø Statins

Ø Angiotensin Converting Enzyme Inhibitors

Ø Griseofulvin

   §    The delay in absorption of interacting drugs could be avoided by taking 1 hour before the administration of Glucagon-like peptide-1 receptor agonists.

   §    Healthcare professionals through the screening, education, and follow up on suspected drug interactions could reduce the risk of adverse effects.

   §    The diabetic patients should always consult their physician and pharmacist before taking any new medication.

   §    The diabetic patients should bring a list of all of the drugs they are taking (or simply bring the drugs themselves), including prescription drugs, over-the-counter drugs, and any supplements, herbal or otherwise, during their visit to the doctor or pharmacist.

   §    The diabetic patients are encouraged to ask their doctor or pharmacist to look over their list for any potentially dangerous combinations.

   §    It is recommended that people fill all their prescriptions at one pharmacy, if possible.

https://www.researchgate.net/publication/333746529_Pharmacologically_relevant_drug_interactions_of_Glucagon-like_peptide-1_receptor_agonists

https://medcraveonline.com/JAPLR/JAPLR-08-00311.pdf

Drug Interactions of α-glucosidase inhibitors:

https://www.researchgate.net/publication/333641356_Pharmacologically_relevant_drug_interactions_of_a-glucosidase_inhibitors

https://medcraveonline.com/JDMDC/JDMDC-06-00178.pdf

   §    The α-glucosidase inhibitors help to decrease postprandial hyperglycemia.

   §    The members of this class include Acarbose, Miglitol and Voglibose.

   §    These drugs could be used alone or as add-on therapy to treat patients with type 2 diabetes taking other antidiabetic drugs.

   §    Acarbose may interact with

Ø Digoxin

Ø Metronidazole

   §    Healthcare professionals through the screening, education, and follow up on suspected drug interactions could reduce the risk of adverse effects.

   §    The diabetic patients should always consult their physician and pharmacist before taking any new medication.

   §    The diabetic patients should bring a list of all of the drugs they are taking (or simply bring the drugs themselves), including prescription drugs, over-the-counter drugs, and any supplements, herbal or otherwise, during their visit to the doctor or pharmacist.

   §    The diabetic patients are encouraged to ask their doctor or pharmacist to look over their list for any potentially dangerous combinations.

   §    It is recommended that people fill all their prescriptions at one pharmacy, if possible.

https://www.researchgate.net/publication/333641356_Pharmacologically_relevant_drug_interactions_of_a-glucosidase_inhibitors

https://medcraveonline.com/JDMDC/JDMDC-06-00178.pdf