A cross-sectional study to determine the potential drug–drug interactions in patients with alcoholic liver disease in a tertiary care hospital

• Published in: National journal of physiology, pharmacy and pharmacology pharmacy and pharmacology, 2024, Vol.14 (10), p.1-2091
• Main Authors: Ravikumar, Divya, R, Chaitra, Shetty, Shabari, Narayan, Arun, Rajarathna, Kavitha
• Format: Article
• Language: English
• Subjects: Age groups; Alcohol; Chi-square test; Comorbidity; Cross-sectional studies; Disease prevention; Drug interactions; Hepatitis; Hospitals; Liver cirrhosis; Liver diseases; Medical records; Metabolism; Metabolites; Mortality; Patients; Polypharmacy; Prescription drugs; Side effects; Software; Student's t-test
• ISSN: 2320-4672; 2231-3206
• DOI: 10.5455/njppp.2024.14.04188202418092024

Background: Alcoholic liver disease (ALD) is a major cause of chronic liver disease worldwide, and it significantly contributes to liver-related mortality on a global scale. These patients often require drug treatment either for liver disease and its complications or for other comorbid conditions. Due to compromised hepatic function and the prevalence of polypharmacy-associated comorbidities, liver disease significantly increases the risk of drug-drug interactions (DDIs) and adverse drug reactions (ADRs). Aims and Objectives: The aim of the study was to determine the potential drug interactions in the pharmacological management of patients with alcoholic liver disease undergoing conservative treatment. Materials and Methods: A descriptive and cross-sectional study was conducted at Victoria Hospital attached to Bangalore Medical College and Research Institute over a period of 3 months. The study analyzed 200 cases of alcoholic liver disease for the presence of potential drug interactions using the LEXICOMP computer program. Results: The study included 200 subjects with alcoholic liver disease. About 92% were males, and 35% were from the age group of 41 to 50 years followed by 28% from 31 to 40 years. Cirrhosis was identified in 53% of the cases. The median number of drugs per patient was 8.8. A total of 118 potential DDIs (pDDIs) were identified averaging 2.5 pDDIs per patient. The common pDDIs were seen with ondansetron, metronidazole, propranolol, rifaximin, and ranitidine. It was noted that polypharmacy exhibited a robust association with the occurrence of drug interactions. The findings highlight a significant association between polypharmacy and the incidence of pDDIs. Conclusion: The complexity of pharmacotherapy in alcoholic liver disease stems from compromised liver function. It is crucial for physicians to be cognizant of the significant DDIs associated with medications used in liver disease treatment, given the heightened susceptibility of these patients to ADRs.