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Cytochrome P450 : Alphabetical drug list
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Drug CYP interaction Clinical consequences
Macrolides (esp erythromycin, troleandromycin)
(clarithromycin, flurithromycin, midecamycin, midecamycin acetate, josamycin and roxithromycin rarely cause trouble [Drug Saf 1995 Aug;13(2):105-22];
azithromycin, dirithromycin, rikamycin, spiramycin do NOT inactivate 3A4)
CYP3A4 : INHIBIT erythromycin & troleandromycin interact with eg. carbamazepine, cyclosporin, terfenadine, astemizole, theophylline [Drug Saf 1995 Aug;13(2):105-22]
maprotiline (antidepressant) 2D6 : metabolism
(possibly also by 2C9 )
interaction potential;
poor metabolisers have high levels and vice versa.
mefenamic acid 2C9 : metabolism ?
meperidine : see pethidine
(S)-mephenytoin CYP2C19 : metabolism ?
(R)-mephobarbital (See also Barbiturates) 2C19 : substrate ?
(S)-mephobarbital (See also Barbiturates) CYP2B6 : metabolism ?
mepyramine (1st generation antihistamine) 2D6 : INHIBITS (Ki ~ 34 nM) ?
mequitazine (selective H1 receptor blocker) 2D6 : METABOLISM [J Pharmacol Exp Ther 1998 Feb;284(2):437-42] (possibly inhibits 3A4 too) ?
mestranol 2C9 : metabolism (to ethinylestradiol) potentially ineffective with 2C9 inhibitors.
methadone 3A4 : substrate interactions with e.g. rifampicin, ?diazepam, nevirapine
2D6 : INHIBITS
methoxsalen 2A6 : potent INHIBITOR ?
1A2 : inhibits ?
methoxyamphetamine 2D6 : metabolism ? (cf. amphetamine)
methoxyflurane 2E1 : metabolism ?
methylenedioxymetamphetamine : see amphetamine
metoclopramide ?? 2D6 (is there any information out there?) ?
(S)-metoprolol (See also beta blockers) 2D6 : metabolism may be clinically significant interaction with 2D6 inhibitors, e.g. quinidine, some SSRIs eg. fluoxetine, norfluoxetine and paroxetine
metronidazole CYP2C9 : INHIBITS ?
3A4 : ? inhibits ?
metyrapone 3A4 : induces ?
CYP11B1 : INHIBITS inhibition of cortisol synthesis ('adrenal inhibition')
mexiletine CYP2D6 : METABOLISM low activity causes toxicity (arrhythmias)
2D6 : inhibits ? interaction with e.g. metoprolol
CYP1A2 : substrate rifampicin, phenytoin, tobacco smoking increase removal; ciprofloxacin & propafenone slow removal; [Clin Pharmacokinet 1999 Nov;37(5):361-84]
CYP1A1 (Ki 0.28) , and ? 1A2 : INHIBITION potential for eg. theophylline toxicity [Eur J Drug Metab Pharmacokinet 1999 Apr-Jun;24(2):149-53]
(S-), (R-) mianserin CYP2D6 : metabolism ( S- ) moderate (or greater) clinical significance; interaction with thioridazine
3A4 : metabolism of both enantiomers interaction with e.g. carbamazepine
mibefradil (selective T-type calcium channel blocker) 3A4 : INHIBITS (potent, irreversible) ? interaction with eg statins (See
[Br J Clin Pharmacol 1999 Mar;47(3):291-8] ), cisapride, and cyclosporin [Nephrol Dial Transplant 1998 Jul;13(7):1787-91]
2D6 : inhibits ?
1A2 : inhibits ?
miconazole 2E1 : inhibits (Ki ~ 4-20 µM) [Xenobiotica 1998 Mar;28(3):293-301] ?
2C9 : INHIBITS See reference for fluconazole!
mifepristone 3A4 : INHIBITS (mechanism-based inactivator) ?
3A4 : METABOLISM ?
mirtazapine (NaSSA = noradrenergic specific serotonergic antidepressant, NOT SSRI) NO significant effect on 2D6, 1A2, 3A4 [Drugs 1999 Apr;57(4):607-31], [Depress Anxiety 1998;7 Suppl 1:24-32] A good interaction profile
midazolam See also benzodiazepines (3A4/5)
CYP3A5 : METABOLISM interaction with eg cimetidine, .. other 3A4 inhibitors (excessive sedation), also itraconazole, grapefruit juice.
minaprine 2D6 : metabolism ?
moclobemide 2C19 : substrate cimetidine inhibits elimination [Clin Pharmacokinet 1995 Nov;29(5):292-332]
2D6 : INHIBITS (may also inhibit 2C19, 1A2) ?
montelukast 3A4 : metabolism ? nil
2C9 : metabolism ? nil


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