Publication

The impact of CYP2D6 mediated drug-drug interaction: A systematic review on a combination of metoprolol and paroxetine/fluoxetine

Bahar, M. A., Kamp, J., Borgsteede, S. D., Hak, E. & Wilffert, B., Dec-2018, In : British Journal of Clinical Pharmacology. 84, 12, p. 2704-2715

Research output: Contribution to journalReview articleAcademicpeer-review

APA

Bahar, M. A., Kamp, J., Borgsteede, S. D., Hak, E., & Wilffert, B. (2018). The impact of CYP2D6 mediated drug-drug interaction: A systematic review on a combination of metoprolol and paroxetine/fluoxetine. British Journal of Clinical Pharmacology, 84(12), 2704-2715. https://doi.org/10.1111/bcp.13741

Author

Bahar, Muh Akbar ; Kamp, Jasper ; Borgsteede, Sander D. ; Hak, Eelko ; Wilffert, Bob. / The impact of CYP2D6 mediated drug-drug interaction : A systematic review on a combination of metoprolol and paroxetine/fluoxetine. In: British Journal of Clinical Pharmacology. 2018 ; Vol. 84, No. 12. pp. 2704-2715.

Harvard

Bahar, MA, Kamp, J, Borgsteede, SD, Hak, E & Wilffert, B 2018, 'The impact of CYP2D6 mediated drug-drug interaction: A systematic review on a combination of metoprolol and paroxetine/fluoxetine', British Journal of Clinical Pharmacology, vol. 84, no. 12, pp. 2704-2715. https://doi.org/10.1111/bcp.13741

Standard

The impact of CYP2D6 mediated drug-drug interaction : A systematic review on a combination of metoprolol and paroxetine/fluoxetine. / Bahar, Muh Akbar; Kamp, Jasper; Borgsteede, Sander D.; Hak, Eelko; Wilffert, Bob.

In: British Journal of Clinical Pharmacology, Vol. 84, No. 12, 12.2018, p. 2704-2715.

Research output: Contribution to journalReview articleAcademicpeer-review

Vancouver

Bahar MA, Kamp J, Borgsteede SD, Hak E, Wilffert B. The impact of CYP2D6 mediated drug-drug interaction: A systematic review on a combination of metoprolol and paroxetine/fluoxetine. British Journal of Clinical Pharmacology. 2018 Dec;84(12):2704-2715. https://doi.org/10.1111/bcp.13741


BibTeX

@article{3d47efd240a04418bbde7a4a8f0a9c0c,
title = "The impact of CYP2D6 mediated drug-drug interaction: A systematic review on a combination of metoprolol and paroxetine/fluoxetine",
abstract = "AIM: Metoprolol (a CYP2D6 substrate) is often co-prescribed with paroxetine/fluoxetine (a CYP2D6 inhibitor) because the clinical relevance of this drug-drug interaction (DDI) is still unclear. This review aimed to systematically evaluate the available evidence and quantify the clinical impact of the DDI.METHOD: Pubmed, Web of Science, Cochrane Library and Embase were searched for studies reporting on the effect of the DDI among adults published until April 2018. Data on pharmacokinetics, pharmacodynamics and clinical outcomes from experimental, observational and case report studies were retrieved. The protocol of this study was registered in PROSPERO (CRD42018093087).RESULTS: We found nine eligible articles that consisted of four experimental and two observational studies as well as three case reports. Experimental studies reported that paroxetine increased the AUC of metoprolol three to five times, and significantly decreased systolic blood pressure and heart rate of patients. Case reports concerned bradycardia and atrioventricular block due to the DDI. Results from observational studies were conflicting. A cohort study indicated that the DDI was significantly associated with the incidence of early discontinuation of metoprolol as an indicator of the emergence of metoprolol-related side effects. In a case-control study, the DDI was not significantly associated with bradycardia.CONCLUSION: Despite the contradictory conclusions from the current literature, the majority of studies suggest that the DDI can lead to adverse clinical consequences. Since alternative antidepressants and beta-blockers with comparable efficacy are available, such DDIs can be avoided. Nonetheless, if prescribing the combination is unavoidable, a dose adjustment or close monitoring of the metoprolol-related side effects is necessary.",
author = "Bahar, {Muh Akbar} and Jasper Kamp and Borgsteede, {Sander D.} and Eelko Hak and Bob Wilffert",
note = "{\textcopyright} 2018 The Authors. British Journal of Clinical Pharmacology published by John Wiley & Sons Ltd on behalf of British Pharmacological Society.",
year = "2018",
month = dec,
doi = "10.1111/bcp.13741",
language = "English",
volume = "84",
pages = "2704--2715",
journal = "British Journal of Clinical Pharmacology",
issn = "0306-5251",
publisher = "Wiley",
number = "12",

}

RIS

TY - JOUR

T1 - The impact of CYP2D6 mediated drug-drug interaction

T2 - A systematic review on a combination of metoprolol and paroxetine/fluoxetine

AU - Bahar, Muh Akbar

AU - Kamp, Jasper

AU - Borgsteede, Sander D.

AU - Hak, Eelko

AU - Wilffert, Bob

N1 - © 2018 The Authors. British Journal of Clinical Pharmacology published by John Wiley & Sons Ltd on behalf of British Pharmacological Society.

PY - 2018/12

Y1 - 2018/12

N2 - AIM: Metoprolol (a CYP2D6 substrate) is often co-prescribed with paroxetine/fluoxetine (a CYP2D6 inhibitor) because the clinical relevance of this drug-drug interaction (DDI) is still unclear. This review aimed to systematically evaluate the available evidence and quantify the clinical impact of the DDI.METHOD: Pubmed, Web of Science, Cochrane Library and Embase were searched for studies reporting on the effect of the DDI among adults published until April 2018. Data on pharmacokinetics, pharmacodynamics and clinical outcomes from experimental, observational and case report studies were retrieved. The protocol of this study was registered in PROSPERO (CRD42018093087).RESULTS: We found nine eligible articles that consisted of four experimental and two observational studies as well as three case reports. Experimental studies reported that paroxetine increased the AUC of metoprolol three to five times, and significantly decreased systolic blood pressure and heart rate of patients. Case reports concerned bradycardia and atrioventricular block due to the DDI. Results from observational studies were conflicting. A cohort study indicated that the DDI was significantly associated with the incidence of early discontinuation of metoprolol as an indicator of the emergence of metoprolol-related side effects. In a case-control study, the DDI was not significantly associated with bradycardia.CONCLUSION: Despite the contradictory conclusions from the current literature, the majority of studies suggest that the DDI can lead to adverse clinical consequences. Since alternative antidepressants and beta-blockers with comparable efficacy are available, such DDIs can be avoided. Nonetheless, if prescribing the combination is unavoidable, a dose adjustment or close monitoring of the metoprolol-related side effects is necessary.

AB - AIM: Metoprolol (a CYP2D6 substrate) is often co-prescribed with paroxetine/fluoxetine (a CYP2D6 inhibitor) because the clinical relevance of this drug-drug interaction (DDI) is still unclear. This review aimed to systematically evaluate the available evidence and quantify the clinical impact of the DDI.METHOD: Pubmed, Web of Science, Cochrane Library and Embase were searched for studies reporting on the effect of the DDI among adults published until April 2018. Data on pharmacokinetics, pharmacodynamics and clinical outcomes from experimental, observational and case report studies were retrieved. The protocol of this study was registered in PROSPERO (CRD42018093087).RESULTS: We found nine eligible articles that consisted of four experimental and two observational studies as well as three case reports. Experimental studies reported that paroxetine increased the AUC of metoprolol three to five times, and significantly decreased systolic blood pressure and heart rate of patients. Case reports concerned bradycardia and atrioventricular block due to the DDI. Results from observational studies were conflicting. A cohort study indicated that the DDI was significantly associated with the incidence of early discontinuation of metoprolol as an indicator of the emergence of metoprolol-related side effects. In a case-control study, the DDI was not significantly associated with bradycardia.CONCLUSION: Despite the contradictory conclusions from the current literature, the majority of studies suggest that the DDI can lead to adverse clinical consequences. Since alternative antidepressants and beta-blockers with comparable efficacy are available, such DDIs can be avoided. Nonetheless, if prescribing the combination is unavoidable, a dose adjustment or close monitoring of the metoprolol-related side effects is necessary.

U2 - 10.1111/bcp.13741

DO - 10.1111/bcp.13741

M3 - Review article

C2 - 30248178

VL - 84

SP - 2704

EP - 2715

JO - British Journal of Clinical Pharmacology

JF - British Journal of Clinical Pharmacology

SN - 0306-5251

IS - 12

ER -

ID: 65344079