Prevalence of the co-prescription of tamoxifen and CYP2D6 inhibitors in Saudi population: A cross sectional study

Consumption of Cytochrome P450 2D6 (CYP2D6) inhibiting drugs along with tamoxifen treatment results in decrease in plasma concentration of endoxifen, the major active tamoxifen metabolite. Simultaneous use of CYP2D6 inhibitors, such as selective serotonin reuptake inhibitors (SSIs), as well as lesser tamoxifen adherence may negatively impact tamoxifen efficacy in patients with breast cancer. The objective of our study was to assess the co-prescription of CYP2D6 inhibitors and tamoxifen use and also to relate concomitant CYP2D6 inhibitor use and tamoxifen adherence to breast cancer in Riyadh, Saudi Arabia. All patients treated for breast cancer who had at least one tamoxifen prescription in their electronic medical records (EMRs) from June 2015 to June 2017 were included. Patients who had other adjuvant hormonal therapy were excluded from the study. In total, 499 patients (25 males and 474 females) with breast cancer using tamoxifen were included. Our study was purely observational study revealed that prescription of weak inhibitors with tamoxifen increased in the second year as opposed to decrease in the prescription of strong inhibitors. Also, a substantial percentage of patient population were found to be non-adherent to the tamoxifen therapy in this study.