The Pharmaceutical Journal Vol 267 No 7169 p495-500
13 October 2001

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Pharmacists could prevent more drug interactions

American researchers have identified pharmacists as an underused intervention point for preventing adverse drug interactions.

They studied the frequency of co-prescription and co-dispensing of cisapride with contraindicated drugs following changes to its labelling (because of adverse events) but before its withdrawal from the market.

Of 131,485 cisapride prescriptions dispensed, 3.4 per cent were for patients who were also taking at least one contraindicated drug. The most frequent were clarithromycin, erythromycin and fluconazole. In 50 per cent of cases, the same doctor prescribed both cisapride and the interacting drug. And in 89 per cent of cases, the same pharmacy dispensed both drugs. The researchers suggest that, based on these figures, the pharmacist might have more opportunity than the doctor to prevent contraindicated co-dispensing.

The number of cases of contraindicated co-dispensing that were prevented by pharmacists was not investigated, nor whether the pharmacist consulted the doctor before dispensing a contraindicated pair of drugs (JAMA 2001;286:1607).

Cisapride (Prepulsid) was withdrawn from the market last year because of an association with serious cardiovascular side effects, particularly when given in combination with certain other medicines (see PJ, 29 July, 2000, p152).

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