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School of Medicine

P450 Drug Interactions
Abbreviated "Clinically Relevant" Table

SUBSTRATES
1A2	2B6	2C8	2C9	2C19	2D6	2E1	3A4,5,7
clozapine cyclobenzaprine duloxetine fluvoxamine haloperidol imipramine mexiletine nabumetone naproxen olanzapine riluzole tacrine² theophylline tizanidine triamterene zileuton zolmitriptan	artemisinin bupropion¹ cyclophosphamide efavirenz¹ ifosfamide ketamine meperidine methadone nevirapine propofol selegiline	paclitaxel torsemide amodiaquine² cerivastatin repaglinide	NSAIDs: diclofenac ibuprofen naproxen piroxicam Oral Hypoglycemics: tolbutamide glipizide glyburide Angiotensin II Blockers: losartan irbesartan Others: celecoxib fluvastatin phenytoin rosiglitazone torsemide valproic acid warfarin zafirlukast	PPIs: esomeprazole lansoprazole omeprazole pantoprazole Anti-epileptics: diazepam phenytoin phenobarbitone Others: amitriptyline carisoprodol citalopram clomipramine clopidogrel cyclophosphamide imipramine labetalol proguanil voriconazole	Beta Blockers: carvedilol S-metoprolol propafenone timolol Antidepressants: amitriptyline clomipramine desipramine duloxetine fluoxetine imipramine paroxetine Antipsychotics: haloperidol risperidone thioridazine Others: aripiprazole atomoxetine codeine dextromethorphan doxepine flecainide mexiletine ondansetron oxycodone risperidone tamoxifen TAMOXIFEN GUIDE tramadol venlafaxine	Anesthetics: enflurane halothane isoflurane methoxyflurane sevoflurane Others: acetaminophen→NAPQI aniline benzene chlorzoxazone ethanol N,N-dimethyl formamide theophylline→8-OH	Macrolide antibiotics: clarithromycin erythromycin (not 3A5) NOT azithromycin telithromycin Anti-arrhythmics: quinidine→3-OH (not 3A5) Benzodiazepines: alprazolam diazepam→3OH midazolam triazolam Immune Modulators: cyclosporine tacrolimus (FK506) sirolimus HIV Antivirals: indinavir ritonavir saquinavir nevirapine Prokinetics: cisapride Antihistamines: astemizole chlorpheniramine Calcium Channel Blockers: amlodipine diltiazem felodipine nifedipine nisoldipine nitrendipine verapamil HMG CoA Reductase Inhibitors: atorvastatin lovastatin NOT pravastatin NOT rosuvastatin simvastatin PDE-5 Inhibitors: sildenafil tadalafil vardenafil Others: alfentanyl aripiprazole boceprevir buspirone carbamazepine gleevec haloperidol pimozide quinine tamoxifen telaprevir trazodone vincristine
INHIBITORS
A Strong inhibitor is one that causes a > 5-fold increase in the plasma AUC values or more than 80% decrease in clearance. A Moderate inhibitor is one that causes a > 2-fold increase in the plasma AUC values or 50-80% decrease in clearance. A Weak inhibitor is one that causes a > 1.25-fold but < 2-fold increase in the plasma AUC values or 20-50% decrease in clearance.
1A2	2B6	2C8	2C9	2C19	2D6	2E1	3A4,5,7
amiodarone cimetidine efavirenz fluoroquinolones fluvoxamine¹ ticlopidine	clopidogrel thiotepa ticlopidine² voriconazole	gemfibrozil montelukast¹	amiodarone efavirenz fluconazole² isoniazid metronidazole paroxetine sulfamethoxazole voriconazole	cimetidine esomeprazole felbamate fluoxetine fluvoxamine isoniazid ketoconazole lansoprazole omeprazole oral contraceptives pantoprazole ticlopidine² voriconazole	bupropion fluoxetine paroxetine quinidine¹ duloxetine amiodarone cimetidine aripiprazole diphenhydramine chlorpheniramine clomipramine doxepin haloperidol methadone ritonavir terbinafine	disulfiram	HIV Antivirals: indinavir nelfinavir ritonavir clarithromycin itraconazole ketoconazole nefazodone erythromycin grapefruit juice verapamil² suboxone diltiazem cimetidine amiodarone NOT azithromycin fluvoxamine troleandomycin voriconazole
INDUCERS
1A2	2B6	2C8	2C9	2C19	2D6	2E1	3A4,5,7
carbamazepine chargrilled meat rifampin tobacco	artemisinin carbamazepine efavirenz nevirapine phenobarbital phenytoin rifampin		carbamazepine nevirapine phenobarbital rifampin St. John's Wort	efavirenz rifampin ritonavir St. John's Wort		ethanol isoniazid	carbamazepine efavirenz nevirapine phenobarbital phenytoin pioglitazone rifabutin rifampin St. John's Wort troglitazone
GENETICS
1A2	2B6	2C8	2C9	2C19	2D6	2E1	3A4,5,7
Chr	Chr	Chr	Chr	Chr	Chr 22	Chr	Chr
			Haplotypes: 2=PM 3=PM	Haplotypes: 2=PM (99% in Asians) 3=PM (87% in Whites)	Haplotypes: 2=EM (similar to WT) 3=PM (truncates protein) 4=PM (non-functional) 5=PM (whole gene del.) 6=PM (truncates protein) 9=IM/EM (reduces func.) 10=IM (reduces func.) 17=IM (reduces func.) 29=IM (reduces func.) 41=IM (reduces func.)
Metabolizer Phenotypes: PM = Poor IM = Intermediate EM = Extensive UM = Ultrarapid

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