What is a Flockhart table?
The table contains lists of drugs in columns under the designation of specific cytochrome P450 isoforms. CYTOCHROME P450 DRUG INTERACTION TABLE. A drug appears in a column if there is published evidence that it is metabolised, at least in part, via that isoform.
What drugs are CYP2C19 inhibitors?
CYP2C19 catalyzes the metabolism of several drugs, including proton pump inhibitors (PPIs) (e.g., omeprazole, lansoprazole, pantoprazole), antidepressants (e.g., citalopram and amitriptyline), antiplatelet drugs (e.g., clopidogrel), antifungals (e.g., voriconazole), and anticancer compounds (e.g., cyclophosphamide).
How many CYP450 enzymes are there?
CYP enzymes have been identified in all kingdoms of life: animals, plants, fungi, protists, bacteria, and archaea, as well as in viruses. However, they are not omnipresent; for example, they have not been found in Escherichia coli. As of 2018, more than 300,000 distinct CYP proteins are known.
Is levothyroxine metabolized by cytochrome P450?
Levothyroxine has a wide drug–drug interaction spectrum, including inhibition of cytochrome P450 (CYP) 3A4 and UGT enzymes (UDP-glucuronosyltransferases), and it has been reported to increase the exposure of numerous drugs, including other tyrosine kinase inhibitors (15).
Is atorvastatin a CYP450 substrate?
Simvastatin and atorvastatin, two widely prescribed cholesterol lowering medicines, are both metabolised by the isoenzyme cytochrome P450 3A4 (CYP3A4).
Who is a CYP2C19 poor metabolizer?
Individuals who carry 2 non-functional copies of the CYP2C19 gene are classified as CYP2C19 poor metabolizers. They have no enzyme activity and cannot activate clopidogrel via the CYP2C19 pathway, which means the drug will have no effect.
Why is it called CYP450?
Cytochromes P450, a family of heme-containing monooxygenases that catalyze a diverse range of oxidative reactions, are so-called due to their maximum absorbance at 450 nm, ie, “Pigment–450 nm,” when bound to carbon monoxide.
Where is P450 found?
Abstract. Cytochrome P450 (CYP) is a large family of well-conserved integral membrane proteins localized primarily in the membrane of the endoplasmic reticulum (ER), where these enzymes metabolize a variety of both endogenous and exogenous compounds.
What CYP metabolizes levothyroxine?
What medications should not be taken with levothyroxine?
Some medicines should not be taken at the same time of day as levothyroxine as they can reduce the amount of levothyroxine your body takes in, including:
- calcium salts.
- iron salts.
- orlistat, a medicine used for weight loss.
- sucralfate, a medicine used to treat stomach ulcers.
Is metoprolol a CYP3A4 inhibitor?
Midazolam 1′-hydroxylation could almost completely be inhibited by 1 μM ketoconazole, at this concentration a specific CYP3A4 inhibitor (Berger et al., 2016). Crucially, metoprolol was also α-hydroxylated by CYP3A4 supersomes, but at a much slower rate compared to midazolam.