Did you know teens are at risk for serious drug-drug interactions?
Girls could be more vulnerable, according to study
Children and adolescents use prescription medications for chronic and acute conditions—sometimes at the same time—which may increase their risk of potentially serious drug-drug interactions, especially for adolescent girls, recent study findings suggest.
"Children may not be using medications as much as adults or the elderly but among those [who] are using them, many are at risk for potentially serious adverse effects due to drug-drug interactions, particularly among teenage girls," lead study author Dima M. Qato, PharmD, MPH, PhD, told Pharmacy Today.
“Everyone that's responsible for either prescribing, dispensing, or providing prescription medications to kids—even parents—need to be more aware of all the medications that children are taking,” said Qato, an associate professor at the University of Illinois at Chicago's College of Pharmacy.
Adverse drug events are among the top causes of injuries and death among children and adolescents in the United States. Prior researchers have attempted to address this concern, but their studies failed to describe simultaneous use of multiple medications among participants or did not distinguish between children and adolescents or by gender. Qato and her colleagues expanded on such research by analyzing data on 23,152 children and adolescents aged 19 years and younger who participated in National Health and Nutrition Examination Surveys from 2003-2004 through 2013-2014.1
They found that nearly one in five (19.8%) used at least one prescription medication in 2013-2014 and 7.5% used two or more prescription medications concurrently. In addition, almost one in twelve (8.2%) of those who used concurrent prescription medications were at risk of a major drug-drug interaction (DDI), Qato and her colleagues report in Pediatrics.
“These adverse interaction effects are not trivial; they are very serious,” Qato said.
Overall, prescription medication use was higher among 13 to 19 year olds (22.8%) than among younger children, but teenage girls accounted for 28% of medication users vs. 17.6% of teenage boys. Teen girls more frequently used both acute and chronic medications, especially antidepressants, antibiotics, analgesics, and antiemetics, whereas teen boys used CNS stimulants more frequently. Concurrent medication use was most common among 6 to 12 year-old boys (12%) and adolescent boys and girls (10%, respectively).1
Using Micromedex the researchers identified 826 potential DDIs, 29 of which were contraindicated, for 156 medications taken by 301 concurrent medication users in 2013-2014, they report.
The most common medication combinations included respiratory or psychotropic medications.
Adolescent girls used drug combinations with potentially major DDIs more frequently than adolescent boys (18.1% vs. 6.6%). This was due to the girls’ increased use of tricyclic antidepressants that interacted with nonsteroidal anti-inflammatory drugs, antiemetics, and other acute medications. What’s more, the prevalence of potential DDIs increased among adolescent girls from 11.8% in 2003-2008 to 18.1% in 2009-2014, the report indicates.