Dear Colleagues,

Drug–drug interactions are unintended reactions, toxic side effects, or a lack of clinical efficacy in the body of an individual when multiple medications are simultaneously administered for one or more diseases.

In pharmacology, drug–drug interactions are usually considered in terms of two principal classes of underlying mechanisms: pharmacodynamic and pharmacokinetic ones. Indeed, the pharmacological effect of one or both drugs may be increased or decreased, or a new and unanticipated adverse effect may be produced.

Concerning pharmacokinetics, drug–drug interactions may result in alterations in drug absorption, distribution, metabolism, and excretion (ADME cycle).

Interactions between drugs at the metabolic level can modify the metabolic enzymes, altering drug activation or inactivation. If the metabolism of a drug is inhibited it will remain in the body for longer, increasing its concentration, potentially causing secondary toxic effects. Conversely, increasing the metabolism of a drug can decrease its body concentration and therapeutic effect.

Pharmacodynamically, drugs can interact by binding to the same receptor. Two receptor agonists or two antagonists would increase the pharmacological actions of both, whereas an agonist and an antagonist would decrease each other’s pharmacological effects. In some interactions, drugs may produce biochemical changes that alter the sensitivity to toxicities produced by other drugs. Finally, when drugs and/or their metabolites are excreted by the kidney, one drug may alter kidney function, so that the excretion of the other is increased or decreased.

Finally, whereas in the majority of cases drug–drug interactions can cause toxic adverse effects, there are also a number of therapeutically beneficial drug interactions.

Classifying, describing, and reporting drug–drug interactions provide important insights into how to predict, detect, and avoid adverse interactions, decreases in pharmacological action, or finally beneficial effects.

This research topic will host original investigations, brief reports, and review papers concerning the latest insights in drug–drug interactions at the pharmacological level.

Subtopics:

• Drug–drug interactions in medicine.
• Drug–drug interactions in cardiology.
• Drug–drug interactions in oncology.
• Drug–drug interactions in pharmacotoxicology.
• Drugs.

Prof. Dr. Francesco Paolo Busardò
Dr. Simona Pichini
Guest Editors

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• drug–drug interactions
• cardiology
• oncology
• pharmacotoxicology