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Cytochrome P-450 2C19 Isoenzyme
Aka: Cytochrome P-450 2C19 Isoenzyme, CYP2C19, CYP2C19 Inducer, CYP2C19 Inhibitor, CYP2C19 Substrate
- See Also
- CYP2C9
- Precautions: Pharmacogenetics
- See Pharmacogenetics
- Poor metabolizers (2-15%, 20% in asians)
- Clopidogrel with reduced conversion to active form (higher risk for stent closure)
- Amitriptyline and Nortriptyline risk of toxicity (reduce starting dose by 50%)
- Citalopram, Escitalopram, Sertraline risk of toxicity (reduce starting dose by 50%)
- Omeprazole blood concentrations are 5x higher (increased efficacy)
- Ultra-Metabolizers (18% of Swedes and 18% of Ethiopians)
- Citalopram, Escitalopram, Sertraline with reduced effect (consider alternative agents)
- Omeprazole blood concentrations are 40% lower
- Reference
- Sim (2006) Clin Pharmacol Ther 79:103-13 [PubMed]
- Interactions: Metabolized by CYP2C19 (Substrates)
- Neuropsychiatric drugs
- Clomipramine
- Imipramine
- Hexobarbital
- Mephobarbital
- Diazepam
- Phenobarbital
- Phenytoin
- Cardiopulmonary Drugs
- Propranolol (Inderal)
- Antibiotics
- Nelfinavir
- Miscellaneous
- Lansoprazole
- Pentamidine
- Felbamate
- Omeprazole (Prilosec)
- Interactions: Inhibitor of CYP2C19
- Neuropsychiatric drugs
- Fluvoxamine (Luvox)
- Antibiotics
- Isoniazid (INH)
- Ritonavir
- Miscellaneous
- Omeprazole (Prilosec)
- Cimetidine
- Interactions: Inducer of CYP2C19
- Neuropsychiatric Drugs
- Carbamazepine
- Phenytoin
- Antibiotics
- Rifampin