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Metabolism-Based Drug-Drug Interactions In Patients With Chronic Respiratory Diseases: A Review Focusing On Drugs Affecting The Respiratory System


Shadi Baniasadi*   Pages 1 - 10 ( 10 )


Background: Chronic respiratory diseases (CRDs) are increasing in prevalence as reported by World Health Organization (WHO). Patients with CRDs usually require co-administration of multiple drugs due to complex pathogenic mechanisms of CRDs and existence of concomitant diseases. Polypharmacy (co-administration of more than four medications) is the main risk factor of occurrence of drug-drug interactions (DDIs) that may lead to reducing treatment efficacy and/or increasing adverse effects.

Methods: This review is literature based that focuses on metabolism-based DDIs, the most prevalent DDIs responsible for difficulties in therapeutic management, in patients with CRDs.

Results: Clinically relevant metabolism-based DDIs occur between drugs used for treatment of respiratory diseases (corticosteroids, oral inhaled bronchodilators, methylxanthines, anti-leukotrienes, antimicrobials, endothelin receptor antagonists, phosphodiesterase inhibitors, antitussives, and antineoplastic agents) and drugs affecting cytochrome P450 (CYP) (inducers and inhibitors). Considering alternative therapies, adjusting medication doses, or monitoring patients during treatment are recommended to prevent harmful consequences of these interactions.

Conclusion: Providing information on clinically relevant interactions of drugs more likely prescribed in daily physicians’ practices is essential to improve patient safety. A list of known metabolism-based interactions of drugs affecting the respiratory systems should be available for physicians involved in treatment of CRDs.


Chronic respiratory diseases, cytochrome P450, drug-drug interactions, enzyme inducers, enzyme inhibitors, metabolism, respiratory system, uridine glucuronosyltransferases


Tracheal Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran

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