title: Drug-drug interactions in pharmacologic management of gastroparesis.
abstract: BACKGROUND
  Gastroparesis is a disorder characterized by delayed gastric emptying due to chronic abnormal gastric motility. The treatment of the disease often entails the co-administration of several classes of pharmacological agents. These agents may be metabolized via the same pathway. Inhibition or induction of a shared metabolic pathway leads to change in the systemic levels of prescribed drugs, possibly leading to undesired clinical outcomes.
  
  
  OBJECTIVE
  This review discusses different pharmacological treatment for gastroparesis patients and describes the potential for drug-drug interactions (DDIs) in some of the combinations that are currently used. Prokinetic agents such as metoclopramide and domperidone are the cornerstone in treatment of gastroparesis. Antiemetic agents such as promethazine and ondansetron are frequently administered to gastroparesis patients to reduce nausea and vomiting. Gastroparesis is prevalent in diabetic patients and therefore antidiabetic agents are also prescribed. Many of these co-administered drugs are metabolized via common drug metabolizing enzymes and this can trigger potential DDIs. The scientific literature was reviewed from the years 1975-2014 for original research articles and reviews that evaluated DDIs in gastroparesis. Many commonly prescribed combinations were predicted to cause potential DDIs in gastroparesis patients. This review will help inform about potential hazardous combinations. This information will hopefully lead to less adverse effects and more successful gastroparesis management.
authors.affiliation: Department of Pharmaceutical Sciences, Temple University School of Pharmacy, Philadelphia, PA, USA.
authors.forename: A S
authors.initials: AS
authors.lastname: Youssef
authors.affiliation: Gastroenterology Section, Temple University School of Medicine, Philadelphia, PA, USA.
authors.forename: H P
authors.initials: HP
authors.lastname: Parkman
authors.affiliation: Department of Pharmaceutical Sciences, Temple University School of Pharmacy, Philadelphia, PA, USA.
authors.forename: S
authors.initials: S
authors.lastname: Nagar
mesh_terms: D004347:Drug Interactions; D004359:Drug Therapy, Combination / Q000009:adverse effects*; D064420:Drug-Related Side Effects and Adverse Reactions; D005765:Gastrointestinal Agents / Q000008:administration & dosage* / Q000009:adverse effects*; D018589:Gastroparesis / Q000188:drug therapy*; D006801:Humans
chemical_list: D005765:Gastrointestinal Agents
keywords: adverse drug reactions; domperidone; drug-drug interaction; gastroparesis; metoclopramide; prokinetic agent