Clinically Relevant Interactions between Atypical Antipsychotics and Anti-Infective Agents

Area of Science:

• Pharmacology
• Clinical Pharmacy
• Infectious Diseases

Background:

• Drug interactions (DIs) between atypical antipsychotics and anti-infective agents are common.
• Understanding the pharmacokinetic (PK) and pharmacodynamic (PD) mechanisms of these DIs is crucial for patient safety.
• Patients with infections often require concurrent treatment with both drug classes, increasing DI risk.

Purpose of the Study:

• To comprehensively review and classify clinically relevant DIs between atypical antipsychotics and anti-infective agents.
• To focus on the pharmacokinetic (PK) and pharmacodynamic (PD) aspects of these drug interactions.
• To provide practical guidance for clinicians managing patients on these medications.

Main Methods:

• Conducted extensive PubMed searches for interactions between 13 atypical antipsychotics and 61 anti-infective agents/classes.
• Included relevant articles from citations and prior author reviews.
• Developed tables categorizing DIs (antibiotic, antitubercular, antifungal, antiviral) with clinical recommendations.

Main Results:

• Identified and classified numerous clinically relevant DIs between atypical antipsychotics and various anti-infective agents.
• Presented practical recommendations for managing antibiotic, antitubercular, antifungal, and antiviral DIs.
• Highlighted that concurrent infections can further influence the PK and PD of both drug classes.

Conclusions:

• Clinically significant drug interactions between atypical antipsychotics and anti-infective agents necessitate careful management.
• The provided tables offer practical guidance for clinicians, based on current literature and understanding of PK/PD mechanisms.
• Ongoing updates are required as new drug interaction information emerges in this field.