Potential Cardiovascular Drug Interactions in Egypt: Incidence, Outcomes, Mechanism, and Management

Abstract

Background/aim: Cardiovascular diseases usually involve multiple drug co-administration giving the potential for many drug-drug interactions. Limited data is available regarding drug interactions of cardiovascular diseases in Egypt. This work studied potential drug-drug interactions of cardiovascular diseases in Egyptian patients with consideration to incidence, types, management, and prevention. Methods: A cross-sectional retrospective study was performed on outpatients with cardiovascular disorders in the Delta region of Egypt. About 4,100 prescriptions were analyzed for drug-drug interactions. Lexi-comp program was used as the screening tool. Results: The frequency of potential drug-drug interactions was 11% of which cardiovascular drugs represent 3 %. Major therapeutic classes of drug interactions with the cardiovascular drugs were analgesics, antiplatelets, anticoagulants, proton pump inhibitors, anti-gout, and Ginkgo herb. The risk for category X drug interaction requiring avoiding combinations was 39% and the risk for category D drug interaction requiring modifying drug was 61%. The main mechanisms for drug interaction were pharmacokinetics “metabolic inhibitions and P-gp inhibition” and pharmacodynamics interaction and the major reported toxicity was bleeding, nephrotoxicity, irregular heartbeats, visual disturbance, and myopathy. Conclusions: Preventive programs are required for the increased incidence of potential cardiovascular drug interaction in Egypt. Drug monitoring, minimizing risk factors, and increasing awareness of potential drug interaction in cardiovascular diseases are recommended in clinical practice in Egypt.