| D
|
| Drug |
CYP interaction |
Clinical consequences |
dapsone
toxicity thought to be related to its hydroxylamine
metabolite (methaemoglobinaemia, haemolysis, agranulocytosis)
| 3A4 : substrate (also 2C9)
| cimetidine may be useful in inhibiting toxic effects!
[Gen Pharmacol 1995 Nov;26(7):1461-7]
|
| 2E1 : may contribute to metabolism
| ?
|
| debrisoquine
| CYP2D6 : metabolism
| ? (the prototype drug for 2D6 metabolism)
|
| delavirdine (NNRTI)
| 3A4 : METABOLISM, also inhibits
(metabolism : ? 2D6)
| interaction potential
|
| desipramine (See also tricyclics)
| 2D6 : metabolism
(? with 1A2 [Hayes])
| impaired metabolism with 2D6 deficiency
|
| 2D6 : ? inhibits
| ?
|
| dexamethasone
| CYP3A4 : INDUCES
| ?
|
| CYP3A4 : metabolism
| ?
|
| CYP? : increased HETE formation in response to angiotensin-1 receptor
stimulation [Biochem Biophys Res Commun 2000 Jun 7; 272(2) : 423-430]
| ?
|
| dexfenfluramine (appetite suppressant)
| CYP2D6 : high affinity metabolism
| poor metabolisers get toxicity (nausea, vomiting)
|
| 1A2 : low affinity metabolism
| ?
|
| dextromethorphan
| CYP2C9 : metabolism
| ?
|
| CYP2C19 : metabolism
| ?
|
| CYP2D6 : metabolism (to DEXTRORPHAN used as a probe for 2D6 activity)
| ?
|
| CYP3A4 : metabolism
| ?
|
| dextropropoxyphene
| CYP2D6 : INHIBITS
| 'significant interaction with antidepressants'
[Acta Psychiatr Scand 1997 Nov;96(5):379-84]
|
| diazepam (See also Benzodiazepines)
| CYP2C8 : metabolised
| ?
|
| 2C19 : metabolism (N-demethylation)
| impaired metabolism in Chinese subjects with 2c19 mutations
|
| 3A4,3A5 : METABOLISM (3 hydroxylation, N-demethylation)
| marked prolongation of diazepam half life with grapefruit
juice! [ Eur J Drug Metab Pharmacokinet 1998 Jan-Mar;23(1):55-9];
NO clinically significant interaction
with itraconazole [Fundam Clin Pharmacol 1996;10(3):314-8]
|
| 2B6 : metabolism
| ?
|
| diclofenac (See also NSAIDs
(CYP2C8 > CYP2C19 = CYP2C18 >> CYP2B6 )
[Biochem Pharmacol 1999 Sep 1;58(5):787-96]
| CYP2C9 : METABOLISM (4-hydroxylation)
| ? see 3A4 below.
|
| CYP2C9 : inhibition?
| reduces quinidine N-oxidation by 27%
[Br J Clin Pharmacol 1999 Dec;48(6):829-38]
|
| 3A4 (5-hydroxylation, product may be hepatotoxic by inhibiting
mitochondrial ATP synthesis)
| low 2C9 + high 3A4 activity could cause hepatotoxicity,
with low antioxidant levels
|
| 2C8 ? metabolism
| ?
|
| dihydrocodeine
| 2D6 : activated to dihydromorphine
| effects as for codeine although
this has been questioned [Br J Clin Pharmacol 1998 Jun;45(6):575-81]
|
| diltiazem (See also Ca channel blockers)
| CYP3A4 : metabolism
| ?
|
| 3A4 : INHIBITS (IC50 ~ 5 µM )
| slowed elimination of eg. midazolam, alfentanil,
[Anesthesiology 1996 Dec;85(6):1246-52] and prednisolone (significant);
also lovastatin
|
| diphenhydramine (1st generation anti-histamine)
| 2D6 : inhibits (Ki ~ 11 µM)
| ?
|
| dirithromycin
| does NOT inhibit 3A4 [Ann Pharmacother 1997 Mar;31(3):349-56]
| Nil (in contrast with many other macrolides)
|
| disopyramide
| 3A4 : METABOLISM
| toxicity with eg. clarithromycin
|
| disulfiram
| CYP2E1 : INHIBITS
{minimal effect on other isoforms , although rat
studies disagree }
| potential for prevention of xenobiotic toxicity.
Enzyme levels return to half normal by day 3, due to 2e1 resynthesis.
{Note: the rare disulfiram hepatotoxicity may be associated with
antibodies to CYP! }
|
| docetaxel (see also taxoids)
| 3A4 : METABOLISM
| metabolism reduced with 3A4 inhibitors;
[Cancer Res 1996 Jan 1;56(1):58-65]
|
| dofetilide
| 3A4 : metabolism
| ? potential for interaction
|
| dolasetron (5HT3 antagonist)
| 3A4 : metabolism
| ?
|
| 2D6 : metabolism {non-significant inhibition of 2D6}
| ?
|
| donepezil (cholinesterase inhibitor : Alzheimer's)
| 2D6 and 3A4 : metabolism
| unclear.
|
| doxorubicin
| 3A4 : metabolism AND inhibition
| interactions with eg paclitaxel
|