Adverse Drug Events Caused by Drugs Contraindicated for Coadministration Reported in the Japanese Adverse Drug Event...

Area of Science:

• Pharmacovigilance
• Clinical Pharmacology
• Drug Safety

Background:

• Package insert warnings for drug-drug interactions can cause alert fatigue due to rare event reporting.
• Existing research focuses on identifying drug-drug interactions but not the adverse events they cause.

Purpose of the Study:

• To investigate the actual incidence of adverse events stemming from contraindicated drug coadministration in clinical practice.
• To assess reporter recognition rates of drug-drug interactions leading to adverse events.

Main Methods:

• Compiled a list of drug combinations contraindicated for coadministration.
• Extracted adverse drug event cases from the Japanese Adverse Drug Event Report database.
• Calculated reporter recognition rates for identified drug-drug interactions.

Main Results:

• Out of 2121 investigated drug pairs, 43 pairs were associated with reported drug-drug interactions.
• Injected drugs and catecholamines were frequently involved.
• Warfarin potassium with miconazole, azathioprine with febuxostat, and warfarin potassium with iguratimod were common oral medication pairs with high recognition rates.

Conclusions:

• A small number of contraindicated drug pairs led to adverse drug events in clinical practice.
• Despite the low incidence, translating these findings into clinical practice is crucial for improving patient safety.
• High reporter recognition for specific drug-drug interactions warrants attention.