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Cytochrome P-450 2C9 Isoenzyme
Aka: Cytochrome P-450 2C9 Isoenzyme, CYP2C9, CYP2C9 Inducer, CYP2C9 Inhibitor, CYP2C9 Substrate
- Precautions: CYP2C9 Deficiency related to Warfarin toxicity
- Higher risk for Warfarin toxicity and bleeding complications
- Start with lower doses
- Reaching a steady-state INR on Warfarin requires >3 months
- Voora (2005) Thromb Haemost 93:700-5 [PubMed]
- Interactions: Metabolized by CYP2C9 (Substrates)
- Cardiopulmonary Drugs
- Carvedilol (Coreg)
- Tolbutamide
- Angiotensin Receptor Blockers (ARBs) affected
- Losartan (Cozaar)
- Irbesartan (Avapro)
- ARBs not affected by Cytochrome P450 System
- Valsartan
- Eprosartan
- Candesartan
- Miscellaneous
- Diclofenac
- Ibuprofen
- Piroxicam
- Celecoxib (Celebrex)
- Warfarin
- Glipizide
- Interactions: Inhibitor of CYP2C9
- Neuropsychiatric drugs
- Fluoxetine (Prozac)
- Cardiopulmonary Drugs
- Amiodarone
- Zafirlukast (Accolate)
- Fluvastatin (Lescol)
- Antibiotics and Antifungals
- Fluconazole (Diflucan)
- Ketoconazole
- Metronidazole (Flagyl)
- Ritonavir
- Trimethoprim-sulfamethoxazole (Septra)
- Interactions: Inducer of CYP2C9
- Neuropsychiatric drugs
- Carbamazepine
- Phenobarbital
- Phenytoin
- Antibiotics
- Rifampin