Exploring co-dispensed drug use in patients on sevelamer or polystyrene sulfonate to identify potential novel binding interactions: a cross sectional in silico study

Background Sevelamer and polystyrene sulfonate are used for treating hyperphosphatemia and hyperkalaemia in chronic kidney disease patients. Because of their binding properties, these resins potentially bind other drugs in the gastrointestinal tract, thereby decreasing their bioavailability and clin...

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Bibliographic Details
Published in:International journal of clinical pharmacy 2022-04, Vol.44 (2), p.389-398
Main Authors: van Berlo - van de Laar, I. R. F, Prins-Can, I, Schuiling-Veninga, C. C. M, Taxis, K, Jansman, F. G. A
Format: Article
Language:English
Subjects:
Bioavailability
Care and treatment
Chemical properties
Chronic kidney failure
Drug interactions
Drug use
Gastrointestinal system
Gastrointestinal tract
Hyperphosphatemia
Kidney diseases
Oral administration
Patients
Pharmacy
Polystyrene
Resins
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Summary:Background Sevelamer and polystyrene sulfonate are used for treating hyperphosphatemia and hyperkalaemia in chronic kidney disease patients. Because of their binding properties, these resins potentially bind other drugs in the gastrointestinal tract, thereby decreasing their bioavailability and clinical effectiveness. Aim The aim of this study was to explore co-dispensed drug use in patients on sevelamer or polystyrene sulfonate to identify potential novel binding interactions. Method In this in silico study, the 100 drugs most frequently co-dispensed with sevelamer/polystyrene sulfonate in the period 2000-2018 were extracted from the University Groningen IADB.nl database. Drugs dispensed to 2.0 were identified as potential interacting drug. For polystyrene sulfonate, drugs with a pKa (base) > 1.5 were identified as potential interacting drug. Results Of the top 100 drugs most frequently co-dispensed with sevelamer/polystyrene sulfonate, 22 and 27 potentially clinically relevant new interacting drugs were identified for sevelamer and polystyrene sulfonate respectively. Conclusion Several potentially relevant novel binding interactions for sevelamer and polystyrene sulfonate were identified based on dispensing data and assessment of chemical properties for which further interaction research is warranted.
ISSN:2210-7703
2210-7711
DOI:10.1007/s11096-021-01355-7