The Pharmaceutical Journal
Vol 270 No 7249 p697
17 May 2003

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Not much to criticise in this edition of Stockley’s drug interactions

‘Stockley’s drug interactions’, 6th edition, edited by Ivan H. Stockley. Pp vi+1080. Price £95.00. London: Pharmaceutical Press; 2002. ISBN 0 85369 504 0.

I sometimes wonder where we would we be without Stockley’s drug interactions. The sixth edition has just been published — 21 years after the first edition.
For hospital and community pharmacists this essential textbook is the automatic first port of call when questions arise about potential drug interactions and how to manage them. From a practical perspective, this issue has become more complex in recent years, largely due to advances in cytochrome P450 research and an enhanced capacity to predict interactions likely to occur with newly introduced drugs. Several recent serious safety issues involving drug interactions come to mind, eg, with bupropion, sildenafil, St John’s Wort and terfenadine. To practise effectively, pharmacists need reliable and comprehensive information on drug interactions in an easy-to-use format.

The new edition of Stockley comprises over 2,500 monographs and for the first time is no longer written by Ivan Stockley alone. The publication has now been taken over by the Pharmaceutical Press and has a team of writers and editorial staff involved in its production. Retaining its familiar format, the book is organised as a series of individual drug-drug monographs under the headings clinical evidence, mechanism, importance and management. The introductory chapter gives an overview of the problem of drug interactions and a detailed discussion of the most common mechanisms, followed by 22 chapters covering interactions with specific drug classes (eg, anticoagulants and anticonvulsants). The short section entitled “Before using this book . . .” is worth reading if you are not familiar with previous editions.

The book is straightforward to use with a clear and well laid out index, which is essential for a text covering thousands of interactions. It is also up to date and covers many recently launched medicines. A range of drug synonyms have been used in the text and the index so that it can be used anywhere that English is understood. Monographs are well referenced, so primary literature can be sought if desired. A criticism noted for earlier editions of Stockley was that the advice given on clinical management of interactions was sometimes weak; this aspect has improved greatly over the years and the advice given is now relevant and practical.

I do not believe there is much to criticise about this edition of Stockley. For the next edition it might be worth considering the inclusion of “at a glance” tables summarising differences in the interaction profiles for agents within commonly used therapeutic classes (eg, selective serotonin reuptake inhibitors, proton pump inhibitors and protease inhibitors). This would certainly be of value in medicines information departments.

For pharmacists, clinicians and other prescribers dealing with drug interaction problems, Stockley’s drug interactions is an invaluable reference source, supporting the provision of evidence-based patient care in this rapidly changing area of practice. To that end, the launch of e-Stockley is also a welcome development.

Anne Lee