Table 5 Most frequent drug-drug exposures with a strong inhibitor in all patients (n = 1221). Classification of the potential drug-drug exposure was determined by the content of the prescribing information associated with the brand-name drug
Potential drug-drug exposure (bold = strong inhibitor) | Frequency | Events per 100 person-years (95%CI) | Number of patients with at least one DDE (%) | Clinical relevance of a potential interaction (as per prescribing information) |
|---|---|---|---|---|
amitriptyline & paroxetine | 29 | 0.56 (0.37–0.80) | 9 (0.74) | Patients taking SSRIs should only be treated with amitriptyline with particular caution [35] [reason not given] |
paroxetine & risperidone | 21 | 0.40 (0.25–0.62) | 6 (0.49) | Paroxetine increases the plasma-concentration of risperidone [36] |
codeine & fluoxetine | 8 | 0.15 (0.07–0.30) | 5 (0.41) | |
amitriptyline & fluoxetine | 16 | 0.31 (0.18–0.50) | 5 (0.41) | Taking fluoxetine and amitriptyline in parallel might result in an increased plasma-concentration of amitriptyline Dose-reduction might be necessary [33] |
fluoxetine & tramadol | 42 | 0.81 (0.58–1.09) | 5 (0.41) | Taking tramadol and fluoxetine in parallel can induce serotonin syndrome [32] |
amlodipine & clarithromycin | 5 | 0.10 (0.03–0.22) | 4 (0.33) | Taking clarithromycin and amlodipine parallel might result in an increased plasma concentration of amlodipine [39] |
clomipramine & paroxetine | 76 | 1.46 (1.15–1.82) | 4 (0.33) | Paroxetine can increase the plasma concentration of clomipramine [40] |
paroxetine & tramadol | 6 | 0.12 (0.04–0.25) | 4 (0.33) | Taking tramadol and SSRIs [i.e., paroxetine] in parallel can induce serotonin syndrome [32]. Patients taking tramadol and paroxetine must be monitored closely [35] |
… | ||||
Sum | 380 | 7.29 (6.57–8.06) | 90 |