Prophylaxis and Treatment - Reactive Management
Healthcare providers are pivotal in the reactive management of potential drug-drug interactions associated with kinase inhibitor treatment. When a drug-drug interaction occurs, general recommendations include:1
- Rank the prescribed drugs according to clinical priority. For example, in a patient taking a kinase inhibitor to treat his cancer and also receiving a statin as a preventative treatment, the statin should be interrupted or changed, not the kinase inhibitor
- Prescribe an alternative, non-interacting, drug
- Stop the target interacting with the drug temporarily
- Adjust dose base on known data or extrapolate information to the target drug with close monitoring of toxicity and side effects during follow up
- Once dosage of two interacting medicines is established clinically, the interaction is considered managed, unless the interacting medicine is stopped or has a dosage change1
It is important to document unexpected observations and report them to the pharmacovigilance network.2
- Bryant L, Fishman T. Clinically important drug-drug interactions and how to manage them. J Prim Health Care 2009; 1: 150-151.
- van Leeuwen RW, van Gelder T, Mathijssen RH, Jansman FG. Drug-drug interactions with tyrosine-kinase inhibitors: a clinical perspective. Lancet Oncol 2014; 15: e315-326.