Frequency and clinical relevance of drug interactions with lovastatin and simvastatin : an observational database study

Posted on February 28, 2008 by DNADiva

COMMENT:: Although clinicians should be aware of potential drug interactions with the statins that are CYP3A4 substrates and potent CYP3A4 inhibitors, the real-life clinical importance of them may have been a bit obscured. This observational database provides evidence of the relative clinical insignificance of these combinations in terms of creatine kinase increases when compared to [...]

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Inhibitory effects of fruit juices on CYP3A activity

Posted on February 26, 2008 by DNADiva

COMMENT: This pair of articles highlights the importance of not relying on invitro data in predicting drug interactions. In the Kim article, pomegranate juice showed invitro inhibition of CYP3A4 that was not supported in an invivo study by Farkas. ABSTRACTS:</font>Farkas D, Oleson LE, Zhao Y, Harmatz JS, Zinny MA, Court MH, Greenblatt DJ.Pomegranate juice does [...]

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Update on Rifampin and Rifabutin Drug Interactions

Posted on February 25, 2008 by DNADiva

COMMENT:: Review of this area is important since in many parts of the world, rifampin is the only drug available for the treatment of TB. There are some notable problems in this review. The protease inhibitors and rifampin are reviewed from the point of view of the effect on the PIs, but the effect of [...]

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Herbal and dietary supplement–drug interactions in patients with chronic illnesses.

Posted on February 22, 2008 by DNADiva

Dr. Oesterheld’s Comment: This article reviews an important drug interaction area. I generally agree with the descriptions of drug interactions with St Johns wort and other herbals with chronically used medications. However, there is a tendency to jump to class conclusions. For example, because there is an interaction with amitriptyline and St John’s wort, it [...]

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Assessment of drug-drug interaction for silymarin

Posted on February 21, 2008 by DNADiva

Dr Oesterheld’s Comment: Silymarin (aka silibinin, silybin) is an extract of milk thistle, an antioxidant herbal that is being tested in a variety of conditions, diabetes, cancer and liver injury and others was originally shown to have in vitro inhibiton against CYP3A4. Two studies, one vitro and one in vivo studies have shown that its [...]

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Inhibition on human liver cytochrome P450 3A4 by constituents of fennel

Posted on February 20, 2008 by DNADiva

Dr. Oesterheld’s Comment: Although clinicians may be well aware of the potential of grapefruit juice to be an inhibitor of CYP3A4, only a few may be aware of the possibility of other CYP-based food- drug interactions.In this study, fennel, an herb and alternate drug is shown to be a modest CYP3A4 inhibitor. Since its inhibition [...]

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CYP2C19 testing to benefit women with breast cancer- predicting those who arelikely to have the best outcomes with tamoxifen

Posted on February 19, 2008 by DNADiva

Dr Oesterheld’s Comment: It has been well established that women with breast cancer who may receive tamoxifen should receive genetic CYP2D6 testing. They may be in a group of individuals who will not receive benefit from tamoxifen because they are slow metabolizers and will not convert the pro-drug tamoxifen to the active metabolite endoxifen which [...]

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Association between caffeine intake and risk of Parkinson’s disease among fast and slow metabolizers

Posted on February 15, 2008 by DNADiva

Dr. Oesterheld’s Comment: There is a major effort afoot to find associations between CYP polymorphisms and risk of disease. There is a polymorhism of CYP1A2 associated with increased CYP1A2 inducibility. This study was undertaken to find an association between this polymorphism and Parkinsonism. Although no such association was found in the study described below, there [...]

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In vitro analysis of the herbal compound Essiac

Posted on February 14, 2008 by DNADiva

Dr. Oesterheld’s Note: Here is the latest in vitro investigation of an herbal drug, Essiac for it inhibitory effects on P450 cytochromes. In Canada it is used as a tea originally developed by the Ojibwa tribe and used for the treatment of cancer and as an antioxidant. It is composed of four herbs Arctium lappa [...]

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Cytochrome P450 2D6 genotype variation and venlafaxine dosage

Posted on February 12, 2008 by DNADiva

Dr. Oesterheld’s comment: This study supports the value of genetic CYP2D6 testing when a patient on venlafaxine has difficulty tolerating a low dose (75Mg) of the drug. Mayo Clin Proc. 2007 Sep;82(9):1065-8. Cytochrome P450 2D6 genotype variation and venlafaxine dosage. McAlpine DE, O’Kane DJ, Black JL, Mrazek DA. Department of Psychiatry and Psychology, Mayo Clinic, [...]

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