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Cytochrome P450 : Alphabetical drug list
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Drug CYP interaction Clinical consequences
paclitaxel 2C8 and 3A4 : metabolism
(used as a probe for 2C8 activity)
interaction with eg doxorubicin ?
pantoprazole (Proton Pump inhibitor) CYP2C19 : substrate (?) no significant interaction with "antipyrine, caffeine, carbamazepine, diazepam, diclofenac, digoxin, ethanol, glibenclamide, a hormonal contraceptive (combination of levonorgestrel and ethinylestradiol), metoprolol, nifedipine, phenprocoumon, phenytoin, theophylline and warfarin", [Int J Clin Pharmacol Ther 1996 Jun;34(6):243-62] nor with nifedipine
paracetamol
(= acetaminophen)
CYP2E1 : METABOLISM high activity causes liver toxicity due to formation of N-acetyl-p-benzoquinone imine (NAPQI). See e.g. [Clin Pharmacol Ther 2000 Mar;67(3):275-82]
CYP1A2 (substrate - minor) ?
paroxetine 2C19 : INHIBITS ?
2D6 : INHIBITS (2 µmol) may increase perphenazine, haloperidol, thioridazine and risperidone levels; clinical interaction with metoprolol reported
pefloxacin (See also Quinolones) 1A2 : inhibits clinically significant [Clin Pharmacol Ther 1999 Mar;65(3):262-74] eg. theophylline
perhexiline (withdrawn d/t nerve toxicity) 2D6 : metabolism ?
perphenazine (Antipsychotic) 2D6 : metabolism ?
2D6 : INHIBITS (IC50 1.5 µM) ?
pethidine {=meperidine} CYP2D6 : metabolism ?
pentobarbitone (See also Barbiturates)
does NOT induce 2C19
CYP2E1 : metabolism ?
phenformin (obsolete drug) 2D6 hypoglycaemia with low 2D6 activity
phenobarbitone / phenobarbital (See also Barbiturates) CYP1A2 : INDUCES potential for multiple interactions
CYP2B6 : INDUCES
CYP2C8 : INDUCES
CYP2C19 : INDUCES
3A4 INDUCES (and 3A5, 3A7)
2C9 INDUCES
phenytoin CYP2C9 : metabolism low 2C9 activity causes toxicity ("sulfaphenazole, phenylbutazone, fluconazole, azapropazone, cotrimoxazole, propoxyphene, miconazole, amiodarone, disulfiram, metronidazole, and stiripentol"); also CYP2C9*3 genotype
CYP2C19 : secondary metabolism interactions with "elbamate, omeprazole, cimetidine, fluoxetine, imipramine, and diazepam" [Epilepsia 1995;36 Suppl 5:S8-13]
CYP3A4 : INDUCES many potential interactions
CYP1A2, 2B6 : INDUCES ?
pimozide CYP3A4 : METABOLISM toxicity : fatal arrhythmias with 3A4 inhibition.
piroxicam CYP2C9 : metabolism
(? and 2C18 )
?
prednisone 2C19 : INDUCES ?
3A4 : metabolism interaction with e.g. diltiazem; fluconazole (Addisonian crisis reported on stopping fluconazole! [Pediatr Transplant 1999 May;3(2):126-30] ); but 'no interaction with grapefruit juice' [Clin Pharmacol Ther 1995 Mar;57(3):318-24]
procainamide CYP2D6 : metabolism (to N-hydroxyprocainamide) extensive metabolizers get drug induced lupus erythematosus
prodipine 2D6 : competitive inhibitor ?
progesterone CYP2C19 : metabolism ?
3A4 : metabolism
proguanil CYP2C19 : low activity (? less activation; less effect)
promethazine (1st generation antihistamine) 2D6 : inhibits (Ki ~ 4-6 µM) ?
propafenone CYP2D6 : metabolism low 2D6 activity causes toxicity (congenital, or with e.g. terbinafine)
CYP1A2 : metabolism low activity : propafenone metabolites may accumulate!
1A2 : inhibits (IC50 20µmol) ? clinically significant (disputed, see [Br J Clin Pharmacol 1998 Apr;45(4):361-8] )
propofol 1A2 : INHIBITS potential for 50% inhibition, ? clinical significance [Xenobiotica 1998 Sep;28(9):845-53]
2C9 : INHIBITS
2D6 : INHIBITS
3A4 : INHIBITS
propranolol (Note: ethinyloestradiol +/- norethindrone has no effect on overall clearance) See also: beta-blockers  
CYP1A2 : metabolism ?
CYP2C19 : metabolism ?
CYP2E1 : metabolism ?
2D6 : metabolism ?
Protease inhibitors (HIV) - Also see the individual drugs CYP3A4 : INHIBIT multiple significant interactions with e.g. non-sedating antihistamines, cisapride, macrolides, ..
CYP3A4 : metabolism ?
1A1 : INDUCE ?
Proton Pump Inhibitors
(e.g.
omeprazole, lansoprazole, pantoprazole)
may induce CYP1A2 {??} NO interaction with theophylline [Br J Clin Pharmacol 1999 Sep;48(3):438-44 ]


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Page author: jo@anaesthetist.com Last update: 2000-6-22