Drug interactions in rheumatoid disease--are they of any clinical importance?

Much of the literature on drug interactions over-emphasizes their importance. A review of the mechanisms of drug interactions and of the clinically important interactions involving drugs commonly used in rheumatology reveals that serious interactions are likely to be uncommon. A practical approach to this problem may be divided into three parts: 1. Be aware of the mechanisms of drug interactions as they may explain some unexpected finding occurring during drug treatment. 2. Remember that serious drug interactions are more likely to involve a drug which possesses a narrow therapeutic range (e.g. oral anticoagulants). 3. When indulging in polypharmacy attempt to ensure that such treatment has real benefits. This last point may be the most important for if it is proven that combined therapy has no advantages then the potential for drug interactions will be much reduced.