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Drug Interactions in Space: a Cause for Concern?
1Institute for Drug Research, School of Pharmacy, Faculty of Medicine, The Hebrew University, Ein Kerem, 91120, Jerusalem, Israel.
Pharmaceutical Research
|June 2, 2019
Summary
Astronauts face numerous potential drug-drug interactions (DDIs) in space, with many unestablished in terrestrial medicine. Avoiding unproven medication combinations is advised until space-specific DDI outcomes are better understood.
Area of Science:
- Space medicine
- Pharmacology
- Astronaut health
Background:
- International Space Station (ISS) crew have access to a growing number of medications.
- Assessing potential drug-drug interactions (DDIs) is crucial for astronaut safety.
Purpose of the Study:
- To evaluate the number, severity, and reliability of potential DDIs among medications available to ISS crew.
- To inform medication management strategies in spaceflight.
Main Methods:
- Utilized clinical decision support systems to identify potential DDIs.
- Searched published lists of medications stocked in ISS medical kits.
Main Results:
- Identified 311 potential DDIs, with about half confirmed by secondary systems.
- Major interactions constituted 23.5%, moderate 68.5%, and minor 8.0%.
- Reliability of alerts was fair (71.1%), with common drugs like zolpidem involved in major interactions due to CNS depression.
Conclusions:
- Many space-related DDIs are not well-established in terrestrial medicine, often relying on class-effects.
- Some drug combinations may have significant clinical consequences for astronauts.
- Future DDI assessments should incorporate space-specific outcomes, and unestablished combinations should be avoided when feasible.
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