Table 3.

Mechanism and advice of drug–drug interactions

Potential clinical outcome	No. of alerts	%*	No. of alerts	%*
Increased risk of side-effects/toxicity	16 280	81.2
Bleeding risk (incl. gastrointestinal ulcer risk)			4410	22.0
Hypotension			2982	14.9
Nephrotoxicity			2535	12.6
Electrolyte disturbances			2115	10.5
Cardiac arrhythmias (incl. QT-prolongation)			1696	8.5
Masking of hypoglycaemia			1226	6.1
Miscellaneous antiepileptics side-effects			415	2.1
Risk of serotonin syndrome			232	1.2
Other			669	3.3
Risk of decreased effectiveness	5 054	25.2
Antihypertensive drugs			1665	8.3
Antibiotics and antimycotics			722	3.6
Biphosphonates			688	3.4
Thyreomimetics			441	2.2
Immunomodifiers			396	2.0
Antiepileptic drugs			229	1.1
Other			913	4.6
Advised management strategy	No. of alerts	%*	No. of alerts	%*	No. of alerts	%*
Monitoring	16 268	81.1
Clinical monitoring of toxicity/effectiveness			3823	19.1
Blood pressure monitoring			1539	7.7
ECG monitoring			1151	5.7
Monitoring of laboratory values			9755	48.6
Kidney function (serum creatinine)					2463	12.3
Blood clotting time (International Normalized Ratio)					2408	12.0
Potassium					2059	10.3
Drugs (Therapeutic Drug Monitoring)					1651	8.2
Glucose					802	4.0
Differential blood count					163	0.8
Liver function					147	0.7
Sodium					62	0.3
Avoid combination	7 330	36.5
Risk-modifying strategy	7 169	35.7
Taking medication when sitting or laying down			2982	14.9
Separate moments of oral administration			2305	11.5
Add gastric protection (proton pump inhibitor)			1789	8.9
Other			88	0.4
Adjust dose/titrate dose slowly	3 429	17.1
Other	889	4.4

^*Percentages do not add up to 100% as one alert could encompass multiple outcomes or management advice.