pubmed: Cytochrome P450 Huma… pubmed: Pharmacogenetics Hum… pubmed: Drug Interactions Hu…Comment from Dr. Oesterheld: Tramadol is a pro-drug and is metabolized to its active metabolite O-desmethyltramadol via CYP2D6. Although there have been case reports of individuals who were ultrarapid metabolizers of CYP2D6 who had adverse drug reactions to this drug, there has been no clinical study that supports this outcome. The authors rightly state that [...]
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Comment from Dr. Oesterheld: Cinacalcet is a calcium- reducing drug commonly used in patients with chromic renal failure/dialysis. Although it was known that cinacalcet is a CYP2D6 inhibitor, and desipramine levels were increased when co-administered with this drug, the Ki of cinacalcet was not known to be similar to quinidine and thus amongst the most [...]
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Comment from Dr. Oesterheld: This article shows how sophisticated clinical studies have become, this study shows that genetic variations of ABCB1 and CYP2C19 can increase lansoprazole concentration and secondarily, decrease the absorption of mycophenolic acid. So this drug interaction is based in genetic variation and changes in absorption. Ther Drug Monit. 2008 Feb;30(1):46-51. Influence of [...]
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Comment from Jessica Oesterheld, M.D.: Although not reported before based on a clinical study, this significant drug interaction is entirely predictable since it is known that terbinafine is a potent inhibitor of CYP2D6 and venlafaxine’s major metabolic pathway is CYP2D6. Venlafaxine’s adverse effects are known to include increased blood pressure at higher doses as well [...]
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Considering that adverse drug reactions are the fourth leading cause of death- responsible for taking over 100,000 U.S. lives per year; you’d think the problem would get more attention. With the recent scare with Dennis Quaid’s children’s accidental heperin overdose and now Heath Ledger’s accidental overdose, maybe this serious public health problem will begin to [...]
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