title: Drug-drug interactions with tyrosine-kinase inhibitors: a clinical perspective.
abstract: In the past decade, many tyrosine-kinase inhibitors have been introduced in oncology and haemato-oncology. Because this new class of drugs is extensively used, serious drug-drug interactions are an increasing risk. In this Review, we give a comprehensive overview of known or suspected drug-drug interactions between tyrosine-kinase inhibitors and other drugs. We discuss all haemato-oncological and oncological tyrosine-kinase inhibitors that had been approved by Aug 1, 2013, by the US Food and Drug Administration or the European Medicines Agency. Various clinically relevant drug interactions with tyrosine-kinase inhibitors have been identified. Most interactions concern altered bioavailability due to altered stomach pH, metabolism by cytochrome P450 isoenzymes, and prolongation of the QTc interval. To guarantee the safe use of tyrosine-kinase inhibitors, a drugs review for each patient is needed. This Review provides specific recommendations to guide haemato-oncologists, oncologists, and clinical pharmacists, through the process of managing drug-drug interactions during treatment with tyrosine-kinase inhibitors in daily clinical practice.
authors.affiliation: Department of Hospital Pharmacy, Erasmus University Medical Centre, Rotterdam, Netherlands.
authors.forename: Roelof W F
authors.initials: RW
authors.lastname: van Leeuwen
authors.affiliation: Department of Hospital Pharmacy, Erasmus University Medical Centre, Rotterdam, Netherlands; Department of Internal Medicine, Erasmus University Medical Centre, Rotterdam, Netherlands.
authors.forename: Teun
authors.initials: T
authors.lastname: van Gelder
authors.affiliation: Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Centre, Rotterdam, Netherlands.
authors.forename: Ron H J
authors.initials: RH
authors.lastname: Mathijssen
authors.affiliation: Department of Clinical Pharmacy, Deventer Hospital, Deventer, Netherlands; Department of Pharmacotherapy and Pharmaceutical Care, University of Groningen, Groningen, Netherlands. Electronic address: f.g.a.jansman@dz.nl.
authors.forename: Frank G A
authors.initials: FG
authors.lastname: Jansman
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects / Q000378:metabolism / Q000493:pharmacokinetics*; D001682:Biological Availability; D004347:Drug Interactions; D006801:Humans; D007408:Intestinal Absorption; D059065:Medication Reconciliation; D047428:Protein Kinase Inhibitors / Q000009:adverse effects / Q000378:metabolism / Q000493:pharmacokinetics*
chemical_list: D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors