POTENTIAL DRUG-DRUG INTERACTIONS BETWEEN ANTI–TUBERCULAR AND NON-TUBERCULAR DRUGS AMONG PATIENTS WITH PULMONARY TUBERCULOSIS IN PUDUCHERRY AND TAMIL NADU

Cathrine John Marie, Senbagavalli PB*, Komala Ezhumalai, Selby Knudsen2, C. Robert Horsburgh, Natasha S. Hochberg, Padmini Salgame, Jerrold Ellner, Sonali Sarkar

ABSTRACT

Tuberculosis (TB) demands a long-term multi-drug treatment. Co-infection in TB patients and concomitant noninfectious disease, particularly with an aging population, undoubtedly necessitates the use of additional drugs. This multi-drug management in a TB population increases the potential for drug interactions. The study focus is to perform a comprehensive analysis of the prevalence of and factors associated with potential interactions of first-line Anti Tubercular Therapy (ATT) drugs and concomitant medications among patients with pulmonary tuberculosis. Newly diagnosed pulmonary TB patients undergoing the standard directly observed treatment short-course (DOTS) 6-month regimen (N=205) enrolled after September 2017 were included in the study. The ATT drugs and the concomitant drugs were checked for their possible drug-drug interactions with their categorization by utilizing the IBM Micromedex solutions online database. Fifty eight patients (28.3%) were taking ATT with other concomitant medications. The most common concomitant medications were oral hypoglycemic drug metformin (75.9%) followed by glimepiride (43.1%) Prevalence of potential drug-drug interactions among the participants were 23.4% (95%CI: 17.8%-29.8%). There were 24 common drug interactions with 19 interactions having potential impact on non-ATT drugs and 5 having potential impact on ATT drugs. The majority (58.4%) of these interactions were moderate followed by major (33.3%) and minor (8.3%). Careful consideration and appropriate use of drugs, thereby avoiding the incidence of drug interactions, is an essential step in mitigation of the effects of complications.

Keywords: Drug-drug Interactions, Anti-tubercular drugs, Concomitant medication, Tuberculosis, Pulmonary tuberculosis.