Cytochrome P450 Table: Substrates Inducers and Inhibitors - Preventing Drug Interactions in Psychiatry

Preventing Adverse Drug Reactions in Psychiatry

Pharmacokinetics: Substrates, Inhibitors and Inducers of CYP 450

CYP450 SUBSTRATES

1A2	2B6	2C19	2D6	3A4
amitriptyline clomipramine imipramine fluvoxamine duloxetine mirtazapine chlorpromazine fluphenazine haloperidol perphenazine clozapine olanzapine ziprasidone ropinirole ALL methylxanthines	selegiline bupropion methadone	amitriptyline clomipramine imipramine diazepam phenytoin phenobarbital citalopram escitalopram fluoxetine sertraline venlafaxine PPIs	tranylcypromine meclobemide amitriptyline clomipramine desipramine doxepin imipramine nortriptyline citalopram fluoxetine escitalopram paroxetine nefazodone trazodone duloxetine venlafaxine chlorpromazine fluphenazine haloperidol thioridazine perphenazine aripiprazole clozapine quetiapine risperidone metoprolol most beta blockers codeine hydrocodone ^prodrug dextromethorphan tramadol ^prodrug tamoxifen ^prodrug ondansetron	amitriptyline clomipramine doxepin imipramine buspirone citalopram escitalopram paroxetine sertraline mirtazapine nefazodone trazodone venlafaxine chlorpromazine haloperidol perphenazine pimozide aripiprazole clozapine quetiapine risperidone ziprasidone triazolo- benzodiazepines zaleplon zolpidem zoplicone carbamazepine valproic acid buprenorphine codeine fentanyl hydrocodone ^prodrug meperidine methadone tramadol ^prodrug statins exceptions pravastatin and rosuvastatin antiarrhythmics CCBs beta blockers macrolide azithromycin
CYP450 INHIBITORS back to top
1A2	2B6	2C19	2D6	3A4
amitriptyline imipramine fluvoxamine duloxetine ciprofloxacin norfloxacin ofloxacin cimetidine	fluvoxamine clopidogrel ticlopidine	amitriptyline imipramine fluoxetine fluvoxamine paroxetine PPIs ^† ketoconazole † lansoprazole is the most potent in vitro inhibitor of 2C19	All TCAs fluoxetine paroxetine bupropion sertraline ^{> 100-150mg} duloxetine fluvoxamine citalopram chlorpromazine fluphenazine haloperidol perphenazine thioridazine aripiprazole clozapine risperidone methadone valproic acid ^mild quinidine ritonavir cimetidine diphenhydramine Vistaril metoclopramide	nefazodone norfluoxetine fluoxetine fluvoxamine haloperidol pimozide ciprofloxacin norfloxacin keto- and itraazole diltiazem verapamil cimetidine protease inhibitors NNRTIs
CYP450 INDUCERS back to top
1A2	2B6	2C19	2D6	3A4
modafinil cruciferous vegetables charbroiled foods	phenobarbital cyclophosphamide	carbamazepine valproic acid phenobarbital phenytoin rifampin	No Inducers!	carbamazepine oxcarbazepine topiramate ^>200mg phenobarbital phenytoin rifampin ritonavir efavirenz St. John's Wort modafinil