Adverse drug interactions

Abstract

Drug interactions should be anticipated. The British National Formulary and pharmacy computer programmes should be used for reference. Clinical problems arise with (i) risky drugs (warfarin, non-steroidal anti-inflammatory drugs, digoxin) and (ii) risky patients (elderly, those with renal insufficiency). The mechanisms most commonly involved are hepatic: cytochrome P450 induction/inhibition. The P-glycoprotein transporter system is now implicated. The final decision rests with the prescriber.