This is an illustrative guide to the cytochrome P450 contribution to drug interactions likely for medication pairs that are substrates, inhibitors or inducers of the same enzyme. More than one-half of patients also carry genetic variations in CYP 1A2, 2C9, 2C19, and 2D6 genes that can dramatically alter patient drug exposures, and for which DNA testing can be ordered. The GeneMedRx drug interaction software provides a more complete and automated tool for comprehensive medication management, with optional input of genetic variations, OTCs, foods, herbals, and other relevant patient factors to produce drug interaction reports based on the cumulative effect of all known drug metabolism variables. Obtain a fully functional 30-day free trial at www.GeneMedRx.com or call 1-800-837-8362. P450 DRUG-INTERACTIONS SUBSTRATES TABLE (compiled by Jessica Oesterheld, M.D.) Substrates (primary enzyme for metabolism) italics = brand name {brackets} = minor or less potent bold = potent (p) = pro-drug > = entire class or group Psychotropics: Psychotropics: Psychotropics: Psychotropics: Psychotropics: Medication: >Calcium Channel Blockers Hormones/chemo Anticonvulsants: therapeutics: Proton Pump Inhibitors: Hypoglycemics: Antihistamines: abuse/treatment: Beta Blockers: >Cough Medicines Opiates: Antibiotics/ Antifungals: Anticonvulsants: Antihistamines:
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This is an illustrative guide to the cytochrome P450 contribution to drug interactions likely for medication pairs that are substrates, inhibitors or inducers of the same enzyme. More than one-half of patients also carry genetic variations in CYP 1A2, 2C9, 2C19, and 2D6 genes that can dramatically alter patient drug exposures, and for which DNA testing can be ordered. The GeneMedRx drug interaction software provides a more complete and automated tool for comprehensive medication management, with optional input of genetic variations, OTCs, foods, herbals, and other relevant patient factors to produce drug interaction reports based on the cumulative effect of all known drug metabolism variables. Obtain a fully functional 30-day free trial at www.GeneMedRx.com or call 1 877 431-4362.
P450 DRUG-INTERACTIONS INHIBITORS TABLE (compiled by Jessica Oesterheld, M.D.) Inhibitors (reduces or blocks the ability of the enzyme to metabolize the substrates) clopidogrel gemfibrozil Plavix atazanavir ciprofloxacin Reyataz enoxacin enoxacin cinacalcet clarithromycin delavirdine flutamide fluvoxamine ticlopidine lomefloxacin Ticlid mexiletine Mexitil fluoxetine norfloxacin goldenseal indinavir sulfaphenazole itraconazole ketoconazole nefazodone propafenone nelfinavir ritonavir and boosted PIs paroxetine saquinavir telithromycin quinidine/quinine voriconazole
ritonavir {sertraline} terbinafine thioridazine ticlopidine
P450 DRUG-INTERACTIONS INDUCERS TABLE (compiled by Jessica Oesterheld, M.D.) Inducers (increases the ability of the enzyme to metabolize the substrates)
primidone rifampins St John’s Wort pioglitazone Actos topiramate at >200 mg/d
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Semantic and Technical Architecture and Implementation Issues Use Cases Data set (for doctors)for unscheduled care as a minumum data set from Patient SummaryGetting a medication based on a prescription from another countryLocal doctor to prescribe medicine to foreign patient• Starting point is to be build on existing elements based on regional / national infra-info structure• lo