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Nightmares and hallucinations with aprepitant and opium powder: a suspected drug-drug interaction
Grégoire Narjoux1, Justine Clarenne2, Brahim Azzouz3,4
1Oncology Day-Hospital, CHU Reims, Avenue General-Koenig, 51100, Reims, France.
Abstract:
Polypharmacy of elderly oncology patients and fragmented medication management are well-known risk factors for drug-drug interactions (DDIs). These interactions can occur among antineoplastic, ongoing chronic treatment(s) and chemotherapy-associated treatments, like antiemetics. Clinically relevant interactions based on enzyme- or transporter-inhibition phenomena of active drugs can increase the frequency of their DDIs. We describe a strongly suspected elderly cancer patient's DDI between aprepitant and opium powder in the context of an irinotecan-based regimen manifested by nightmares and visual hallucinations. We discuss this DDI's hypothetical pharmacological mechanisms and management.
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