Drug-Drug Interactions

DDIs remain a major safety concern with post-IRA polypharmacy increasing complexity. The session covers CYP450 enzyme interactions (3A4, 2D6, 2C9, 2C19), transporter-mediated DDIs (P-gp, OATP1B1, OATP1B3, BCRP), DOAC drug interactions, AI and NMR-based DDI prediction, FDA in vitro DDI guidance, and clinical-decision-support tools (Lexicomp, Micromedex). Discussion addresses pharmacogenomic-DDI interaction, the comparison of theoretical vs clinically-relevant DDIs, herb-drug interactions, biosimilar-DDI considerations, and emerging DDI databases with ML-augmented predictions.