Warfarin, aspirin, and sertraline were among the most frequently reported medications involved in drug–drug interactions, according to a recent study.

In a retrospective descriptive analysis researchers examined drug–drug interaction reports submitted to the Food and Drug Administration Adverse Event Reporting System. The investigation aimed to characterize the scope, outcomes, and pharmacologic profiles of medications most frequently implicated in drug–drug interactions (DDIs)—a preventable source of adverse drug events and patient harm.

Using the Food and Drug Administration Adverse Event Reporting System database, the researchers identified all DDI-related adverse event reports filed by March 31, 2024. Data were retrieved using targeted reaction terms such as “drug interaction,” “labeled DDI issue,” “potentiating drug interaction", and “labeled DDI medication error.”  Reports submitted after the cutoff date were excluded. Variables analyzed included patient demographics, reporting source, medication type, and clinical outcomes. Descriptive statistics were used to summarize findings as frequencies and percentages.

The analysis identified 177,174 DDI reports in total, of which 154,547 were classified as significant interactions and 14,821 (8.4%) resulted in death. More than 44% (78,106) of cases required hospitalization, 9.3% (16,417) were deemed life-threatening, and 2.8% (4,876) led to disability. Most affected patients were between 18 and 64 years of age (52.5%), followed by those aged 65 to 85 years (36.8%). Women represented 52.8% of the reported cases, while men accounted for 47.2%. Most submissions (74.8%) were filed by health care professionals, who accounted for the majority of pharmacovigilance reports.

The most implicated medications were warfarin sodium (4.3%), aspirin (4.2%), sertraline hydrochloride (3.2%), tacrolimus (3.1%), and simvastatin (2.9%). Among drugs associated with fatal outcomes, diazepam (6.7%), aspirin (6.0%), and acetaminophen (4.5%) were most frequently reported. Simvastatin (7.8%), omeprazole (6.3%), and metoclopramide (10.4%) were the leading contributors to disability, whereas aspirin (5.5%), warfarin sodium (5.1%), and furosemide (4.2%) were commonly associated with hospitalization.

"Health care practitioners should educate their patients about potential adverse events, such as drug interactions, and how to avoid them," wrote lead study author Abdullah Alahmari, PhD, of the Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al Kharj, Saudi Arabia, and colleagues.

The authors reported no conflict of interest.

Source: Medicine