PMID- 31826670 OWN - NLM STAT- MEDLINE DCOM- 20200414 LR - 20200414 IS - 1097-9883 (Electronic) IS - 0360-2532 (Linking) VI - 52 IP - 1 DP - 2020 Feb TI - Adverse pharmacokinetic interactions between illicit substances and clinical drugs. PG - 44-65 LID - 10.1080/03602532.2019.1697283 [doi] AB - Adverse pharmacokinetic interactions between illicit substances and clinical drugs are of a significant health concern. Illicit substances are taken by healthy individuals as well as by patients with medical conditions such as mental illnesses, acquired immunodeficiency syndrome, diabetes mellitus and cancer. Many individuals that use illicit substances simultaneously take clinical drugs meant for targeted treatment. This concomitant usage can lead to life-threatening pharmacokinetic interactions between illicit substances and clinical drugs. Optimal levels and activity of drug-metabolizing enzymes and drug-transporters are crucial for metabolism and disposition of illicit substances as well as clinical drugs. However, both illicit substances and clinical drugs can induce changes in the expression and/or activity of drug-metabolizing enzymes and drug-transporters. Consequently, with concomitant usage, illicit substances can adversely influence the therapeutic outcome of coadministered clinical drugs. Likewise, clinical drugs can adversely affect the response of coadministered illicit substances. While the interactions between illicit substances and clinical drugs pose a tremendous health and financial burden, they lack a similar level of attention as drug-drug, food-drug, supplement-drug, herb-drug, disease-drug, or other substance-drug interactions such as alcohol-drug and tobacco-drug interactions. This review highlights the clinical pharmacokinetic interactions between clinical drugs and commonly used illicit substances such as cannabis, cocaine and 3, 4-Methylenedioxymethamphetamine (MDMA). Rigorous efforts are warranted to further understand the underlying mechanisms responsible for these clinical pharmacokinetic interactions. It is also critical to extend the awareness of the life-threatening adverse interactions to both health care professionals and patients. FAU - Abbott, Kodye L AU - Abbott KL AD - Department of Anatomy, Physiology and Pharmacology, College of Veterinary Medicine, Auburn University, Auburn, AL, USA. AD - Auburn University Research Initiative in Cancer, Auburn University, Auburn, AL, USA. FAU - Flannery, Patrick C AU - Flannery PC AD - College of Osteopathic Medicine, Rocky Vista University, Parker, CO, USA. FAU - Gill, Kristina S AU - Gill KS AD - Department of Anatomy, Physiology and Pharmacology, College of Veterinary Medicine, Auburn University, Auburn, AL, USA. AD - Auburn University Research Initiative in Cancer, Auburn University, Auburn, AL, USA. FAU - Boothe, Dawn M AU - Boothe DM AD - Department of Anatomy, Physiology and Pharmacology, College of Veterinary Medicine, Auburn University, Auburn, AL, USA. AD - Auburn University Research Initiative in Cancer, Auburn University, Auburn, AL, USA. FAU - Dhanasekaran, Muralikrishnan AU - Dhanasekaran M AD - Auburn University Research Initiative in Cancer, Auburn University, Auburn, AL, USA. AD - Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, AL, USA. FAU - Mani, Sridhar AU - Mani S AD - Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, NY, USA. FAU - Pondugula, Satyanarayana R AU - Pondugula SR AD - Department of Anatomy, Physiology and Pharmacology, College of Veterinary Medicine, Auburn University, Auburn, AL, USA. AD - Auburn University Research Initiative in Cancer, Auburn University, Auburn, AL, USA. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't PT - Review DEP - 20191211 PL - England TA - Drug Metab Rev JT - Drug metabolism reviews JID - 0322067 RN - 0 (Illicit Drugs) RN - 0 (Prescription Drugs) SB - IM MH - Animals MH - Drug Interactions MH - Humans MH - Illicit Drugs/adverse effects/*pharmacokinetics/pharmacology MH - Prescription Drugs/adverse effects/*pharmacokinetics/pharmacology MH - Substance-Related Disorders/metabolism OTO - NOTNLM OT - CYP OT - Illicit substances OT - MDMA OT - adverse drug interactions OT - cannabis OT - cocaine OT - drug-metabolizing enzymes OT - drug-transporters EDAT- 2019/12/13 06:00 MHDA- 2020/04/15 06:00 CRDT- 2019/12/13 06:00 PHST- 2019/12/13 06:00 [pubmed] PHST- 2020/04/15 06:00 [medline] PHST- 2019/12/13 06:00 [entrez] AID - 10.1080/03602532.2019.1697283 [doi] PST - ppublish SO - Drug Metab Rev. 2020 Feb;52(1):44-65. doi: 10.1080/03602532.2019.1697283. Epub 2019 Dec 11.