DRUG-DRUG INTERACTION AND TREATMENT ERRORS IN HYPERTENSIVE PATIENTS

Abstract

Hypertension is a prevalent chronic disease often requiring multidrug therapy, which increases the risk of drug–drug interactions (DDIs) and treatment errors. This study aimed to identify the prevalence, types, and clinical implications of DDIs in prescriptions for hypertensive patients in a secondary care hospital in Pakistan. A retrospective review of 124 prescriptions over nine months was conducted, and interactions were analyzed using Medscape software. A total of 535 DDIs were detected. Pharmacodynamic interactions were more common (56%) than pharmacokinetic ones (43.9%). Among pharmacokinetic interactions, metabolism-related changes (57.4%) were most frequent, while synergistic effects (51.1%) dominated pharmacodynamic interactions. Frequently involved drugs included losartan, clopidogrel, bisoprolol, and furosemide, often prescribed alongside NSAIDs, PPIs, and anticoagulants. Notable clinically significant interactions were observed, including ACE inhibitors with NSAIDs and clopidogrel with omeprazole, which may lead to renal impairment, reduced efficacy, or increased bleeding risk. The findings underscore the importance of careful monitoring, dose adjustment, and judicious prescribing to minimize harmful DDIs in hypertensive patients. Strengthening prescribing practices and clinical oversight is essential to improve therapeutic outcomes and patient safety in polypharmacy settings.