| M
|
| 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
|