{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T16:30:38Z","timestamp":1785429038121,"version":"3.56.0"},"reference-count":37,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T00:00:00Z","timestamp":1781913600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003094","name":"F\u00f6rdergemeinschaft Deutsche Kinderherzzentren","doi-asserted-by":"publisher","award":["W-B-009\/2020"],"award-info":[{"award-number":["W-B-009\/2020"]}],"id":[{"id":"10.13039\/501100003094","id-type":"DOI","asserted-by":"publisher"}]},{"award":["W-B-009\/2020"],"award-info":[{"award-number":["W-B-009\/2020"]}],"id":[{"id":"https:\/\/ror.org\/05qfkt964","id-type":"ROR","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002347","name":"Federal Ministry of Education and Research","doi-asserted-by":"publisher","award":["01GI0601"],"award-info":[{"award-number":["01GI0601"]}],"id":[{"id":"10.13039\/501100002347","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002347","name":"Federal Ministry of Education and Research","doi-asserted-by":"publisher","award":["01KX2140"],"award-info":[{"award-number":["01KX2140"]}],"id":[{"id":"10.13039\/501100002347","id-type":"DOI","asserted-by":"publisher"}]},{"award":["01GI0601"],"award-info":[{"award-number":["01GI0601"]}],"id":[{"id":"https:\/\/ror.org\/04pz7b180","id-type":"ROR","asserted-by":"publisher"}]},{"award":["01KX2140"],"award-info":[{"award-number":["01KX2140"]}],"id":[{"id":"https:\/\/ror.org\/04pz7b180","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Congenital heart defects (CHD) are the most common congenital malformations and often require complex, lifelong pharmacotherapy. In pediatric CHD populations, multidrug regimens targeting cardiac function and comorbidities predispose patients to polypharmacy. At the molecular level, concomitant drug use increases the risk of pharmacokinetic and pharmacodynamic interactions. Methods: This study aimed to characterize medication patterns and assess polypharmacy and potential drug\u2013drug interactions in patients with CHD. A cross-sectional online survey was conducted in collaboration with the German National Register for Congenital Heart Defects (NRCHD) between November and December 2021. Patients aged 6\u201317 years with CHD were eligible for inclusion. Participants reported their current medications in open-ended questions. Drugs were categorized into pharmacological classes, and common drug combinations were evaluated for potential interactions. Results: Of 894 participants included in the analysis, 372 reported current medication use. Among these, 179 (48.1%) met criteria for polypharmacy (\u22652 drugs). Polypharmacy was more frequent in patients with higher disease severity and comorbidity burden. Several drug combinations showed potential for clinically relevant pharmacokinetic and pharmacodynamic interactions, including mechanisms involving renal electrolyte handling, altered protein binding, cytochrome P450-mediated metabolism, and additive pharmacodynamic effects. Conclusions: Children with CHD are exposed to complex multidrug regimens with a considerable interaction risk, underscoring the need for systematic medication review and mechanistically informed pharmacological management in pediatric CHD care.<\/jats:p>","DOI":"10.3390\/jcm15124802","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T01:03:23Z","timestamp":1782263003000},"page":"4802","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Polypharmacy and Drug Interaction Risk in Children and Adolescents with Congenital Heart Defects: Insights from a Nationwide Survey"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-5240-591X","authenticated-orcid":false,"given":"Kim Sarah","family":"Fritz","sequence":"first","affiliation":[{"name":"Deutsches Herzzentrum der Charit\u00e9, Department of Congenital Heart Disease\u2014Pediatric Cardiology, 13353 Berlin, Germany"},{"name":"Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, 13353 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul C.","family":"Helm","sequence":"additional","affiliation":[{"name":"National Register for Congenital Heart Defects, 13353 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6473-7743","authenticated-orcid":false,"given":"Dominik","family":"Tobias","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, University Childrens Hospital Ulm, 89075 Ulm, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2095-1316","authenticated-orcid":false,"given":"Janina","family":"Semmler","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, 13353 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jannos","family":"Siaplaouras","sequence":"additional","affiliation":[{"name":"Pediatrics and Interprofessional Care, University of Applied Sciences Fulda, Health Sciences, 36037 Fulda, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Apitz","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, University Childrens Hospital Ulm, 89075 Ulm, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1956-5573","authenticated-orcid":false,"given":"Constanze","family":"Pfitzer","sequence":"additional","affiliation":[{"name":"Deutsches Herzzentrum der Charit\u00e9, Department of Congenital Heart Disease\u2014Pediatric Cardiology, 13353 Berlin, Germany"},{"name":"Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, 13353 Berlin, Germany"},{"name":"National Register for Congenital Heart Defects, 13353 Berlin, Germany"},{"name":"Competence Network for Congenital Heart Defects, 13353 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2241","DOI":"10.1016\/j.jacc.2011.08.025","article-title":"Birth prevalence of congenital heart disease worldwide: A systematic review and meta-analysis","volume":"58","author":"Konings","year":"2011","journal-title":"J. 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