Drug interactions: clinical significance.

Abstract

The potential for drug interactions exists in one of thirteen prescriptions, according to a recent study in California.13 There is little doubt that interactions between drugs can have serious clinical consequences, although in general their importance has been overestimated. Recently, physicians have become affiicted by a new disorder, the “drug‐interaction‐anxiety‐syndrome.” In its extreme form, the physician develops therapeutic paralysis that can be quite harmful to the patient, who thereby receives inadequate therapy. A misinterpretation of the importance of drug interactions has arisen because long, uncritical lists of supposed interactions have been published, but are based on animal studies, case reports, and clinical impression without confirmation of their clinical significance. Even when specific drug interactions do occur in humans, their clinical consequences still depend upon the dose, sequence of administration, and, within the patient, genetically controlled factors related to drug metabolism and response.