This document is a quick and concise evidence-based summary to provide additional information, instruction, or guidance to complement a treatment protocol or clinical resource document.
The tables of drug interactions are not an exhaustive list. For a more comprehensive list and for detailed information on specific drug interactions and clinical management, please refer to the specific drug product information and other key resources (examples below).
Cancer Drug Interactions is a freely available, independently developed website with ‘traffic light’ classifications to facilitate the awareness of potential drug-drug interactions between cancer medicines and frequently used co-medications https://cancer-druginteractions.org/checker
For a complete list of CYP inducers, inhibitors and substrates please see Flockhart DA. Drug Interactions: Cytochrome P450 Drug Interaction Table. Indiana University School of Medicine (2021). https://drug-interactions.medicine.iu.edu/MainTable.aspx
The drug interaction tables in eviQ protocols are adapted from a systematic review using individual product information and the following resources:
MIMS Online, MIMS Australia Pty Ltd 2021. Available at https://www.mims.com.au/
Australian Medicines Handbook 2021. Available at: http://www.amh.net.au
IBM Micromedex © Copyright IBM Corporation 2021. Available at: https://www.micromedexsolutions.com/home/dispatch/ssl/true
Lexicomp® Drug Information accessed via UpToDate: Evidence-based Clinical Decision Support. 2021 Wolters Kluwer Health. Available at https://www.wolterskluwer.com/en/solutions/uptodate
electronic Medicines Compendium (eMC), Datapharm Communications Ltd 2020, Leatherhead, Surrey, England. Available at: http://www.medicines.org.uk/emc
The Australian Immunisation Handbook, Australian Government, Department of Health, Canberra, ACT. Available at: https://immunisationhandbook.health.gov.au/
Natural medicines interaction checker ©2021 Therapeutic Research Center. Available at: https://naturalmedicines.therapeuticresearch.com/
BC Cancer Agency Cancer Drug Manual 2021. Available at www.bccancer.bc.ca/health-professionals/clinical-resources/cancer-drug-manual
Cancer Care Ontario Drug Formulary 2021. Available at: https://www.cancercareontario.ca/en/cancer-treatments/chemotherapy/drug-formulary
Further information on the rationale for limiting tables contents to those interactions deemed clinically relevant:
Many chemotherapy regimens contain interacting drugs. In some instances the combinations have been intentionally employed to take advantage of the interaction because of a synergistic effect. In these situations, dosages within a regimen will usually have been adapted to account for the interaction and the interaction may not be listed in the eviQ protocol for this reason.
An interaction may not be listed where an interacting drug combination cannot be avoided due to the therapeutic intent of the regimen or the common existence of co-morbidities that require treatment with interacting drugs.
Some drugs that have multiple interactions (e.g. clozapine, anti-retrovirals) are rarely used in cancer patients and/or are independently carefully monitored in patients taking them; these may also be omitted from listing in eviQ protocols.
In all cases, clinicians are advised that where any drugs with overlapping toxicities are combined, there is a need for close and careful monitoring.
Version 2: Updated references and links. Removed the following links:
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https://www.eviq.org.au/p/3348
29 Mar 2024
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