title: Adverse drug reactions caused by drug-drug interactions reported to Croatian Agency for Medicinal Products and Medical Devices: a retrospective observational study.
abstract: OBJECTIVE
  To analyze potential and actual drug-drug interactions reported to the Spontaneous Reporting Database of the Croatian Agency for Medicinal Products and Medical Devices (HALMED) and determine their incidence.
  
  
  METHODS
  In this retrospective observational study performed from March 2005 to December 2008, we detected potential and actual drug-drug interactions using interaction programs and analyzed them.
  
  
  RESULTS
  HALMED received 1209 reports involving at least two drugs. There were 468 (38.7%) reports on potential drug-drug interactions, 94 of which (7.8% of total reports) were actual drug-drug interactions. Among actual drug-drug interaction reports, the proportion of serious adverse drug reactions (53 out of 94) and the number of drugs (n=4) was significantly higher (P<0.001) than among the remaining reports (580 out of 1982; n=2, respectively). Actual drug-drug interactions most frequently involved nervous system agents (34.0%), and interactions caused by antiplatelet, anticoagulant, and non-steroidal anti-inflammatory drugs were in most cases serious. In only 12 out of 94 reports, actual drug-drug interactions were recognized by the reporter.
  
  
  CONCLUSIONS
  The study confirmed that the Spontaneous Reporting Database was a valuable resource for detecting actual drug-drug interactions. Also, it identified drugs leading to serious adverse drug reactions and deaths, thus indicating the areas which should be in the focus of health care education.
authors: Pharmacovigilance Department, Agency for Medicinal Products and Medical Devices, Zagreb, Croatia. nikica.mirosevic@halmed.hr
authors: Nikica
authors: N
authors: Mirosevic Skvrce
authors: Viola
authors: V
authors: Macolic Sarinic
authors: Iva
authors: I
authors: Mucalo
authors: Darko
authors: D
authors: Krnic
authors: Nada
authors: N
authors: Bozina
authors: Sinisa
authors: S
authors: Tomic
mesh_terms: D016907:Adverse Drug Reaction Reporting Systems / Q000706:statistics & numerical data; D017523:Croatia / Q000453:epidemiology; D004347:Drug Interactions; D064420:Drug-Related Side Effects and Adverse Reactions / Q000150:complications / Q000401:mortality; D005260:Female; D006077:Government Agencies; D006801:Humans; D015994:Incidence; D008297:Male; D019338:Polypharmacy; D012189:Retrospective Studies