TABLE 4.
Potential effects, frequency of the 10 most prevalent class D drug-drug interactions and real drug-drug interactions in the study population.
| Class | Drug pair | Real DDI DIPS score (causal relationship) | Frequency (number of real DDI) | Potential effects | Time (days) to develop ADEs after drug combination | Management |
|---|---|---|---|---|---|---|
| D | Remifentanil + Propofol | NA | 71 (NA) | enhance the CNS depressant effect | NA | NA |
| Tacrolimus + Voriconazole | 6 | 44 (9 renal, 4 liver) | increase the serum levels of Tac causing renal or hepatic dysfunction | 6.2 ± 2.5 (3–9) | Reduce dose of Tac, monitor Tac concentrations, renal function and liver function | |
| Remifentanil + Linezolid | - | 30 (0) | Increase risk of opioid toxicity and enhance the serotonergic effect | - | - | |
| Noradrenaline + Linezolid | - | 30 (0) | enhance the hypertensive effect of Sympathomimetics | - | - | |
| Remifentanil + Pregabalin | NA | 29 (NA) | enhance the CNS depressant effect | NA | NA | |
| Remifentanil + Midazolam | NA | 24 (NA) | enhance the CNS depressant effect | NA | NA | |
| Prednisone + Sodium Bicarbonate | NA | 20 (NA) | decrease the bioavailability of Corticosteroids | NA | NA | |
| Prednisone + Calcium Carbonate | NA | 18 (NA) | decrease the bioavailability of Corticosteroids | NA | NA | |
| Remifentanil + Gabapentin | NA | 16 (NA) | enhance the CNS depressant effect | NA | NA | |
| Tacrolimus + Posaconazole | 6 | 15 (2 liver, 1 renal) | increase the serum concentration of Tac | 14.7 ± 9.3 (7–25) | Reduce dose of Tac, monitor Tac concentrations, renal function and liver function |
DIPS, drug interaction probability scale; CNS, central nervous system; NA, not applicable (NA, is used when data cannot be collected), Tac, tacrolimus.