Inhibition of human cytochrome P450 isoforms by nonnucleoside reverse transcriptase inhibitors

L. L. Von Moltke, D. J. Greenblatt, B. W. Granda, G. M. Giancarlo, S. X. Duan, Johanna P. Daily, J. S. Harmatz, R. I. Shader

Research output: Contribution to journalArticle

104 Citations (Scopus)

Abstract

The capacity of three clinically available nonnucleoside reverse transcriptase inhibitors (NNRTIs) to inhibit the activity of human cytochromes P450 (CYPs) was studied in vitro using human liver microsomes. Delavirdine, nevirapine, and efavirenz produced negligible inhibition of phenacetin O-deethylation (CYP1A2) or dextromethorphan O-demethylation (CYP2D6). Nevirapine did not inhibit hydroxylation of tolbutamide (CYP2C9) or S-mephenytoin (CYP2C19), but these CYP isoforms were importantly inhibited by delavirdine and efavirenz. This indicates the likelihood of significantly impaired clearance of CYP2C substrate drugs (such as phenytoin, tolbutamide, and warfarin) upon initial exposure to these two NNRTIs. Delavirdine and efavirenz (but not nevirapine) also were strong inhibitors of CYP3A, consistent with clinical hazards of initial cotreatment with either of these drugs and substrates of CYP3A. The in vitro microsomal model provides relevant predictive data on probable drug interactions with NNRTIs when the mechanism is inhibition of CYP-mediated drug biotransformation. However, the model does not incorporate interactions attributable to enzyme induction. (C) 2001 the American College of Clinical Pharmacology.

Original languageEnglish (US)
Pages (from-to)85-91
Number of pages7
JournalJournal of Clinical Pharmacology
Volume41
Issue number1
StatePublished - 2001
Externally publishedYes

Fingerprint

efavirenz
Delavirdine
Nevirapine
Reverse Transcriptase Inhibitors
Cytochrome P-450 Enzyme System
Tolbutamide
Protein Isoforms
Mephenytoin
Pharmaceutical Preparations
Phenacetin
Dextromethorphan
Cytochrome P-450 CYP3A
Cytochrome P-450 CYP1A2
Cytochrome P-450 CYP2D6
Enzyme Induction
Phenytoin
Liver Microsomes
Warfarin
Hydroxylation
Biotransformation

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology, Toxicology and Pharmaceutics(all)

Cite this

Von Moltke, L. L., Greenblatt, D. J., Granda, B. W., Giancarlo, G. M., Duan, S. X., Daily, J. P., ... Shader, R. I. (2001). Inhibition of human cytochrome P450 isoforms by nonnucleoside reverse transcriptase inhibitors. Journal of Clinical Pharmacology, 41(1), 85-91.

Inhibition of human cytochrome P450 isoforms by nonnucleoside reverse transcriptase inhibitors. / Von Moltke, L. L.; Greenblatt, D. J.; Granda, B. W.; Giancarlo, G. M.; Duan, S. X.; Daily, Johanna P.; Harmatz, J. S.; Shader, R. I.

In: Journal of Clinical Pharmacology, Vol. 41, No. 1, 2001, p. 85-91.

Research output: Contribution to journalArticle

Von Moltke, LL, Greenblatt, DJ, Granda, BW, Giancarlo, GM, Duan, SX, Daily, JP, Harmatz, JS & Shader, RI 2001, 'Inhibition of human cytochrome P450 isoforms by nonnucleoside reverse transcriptase inhibitors', Journal of Clinical Pharmacology, vol. 41, no. 1, pp. 85-91.
Von Moltke LL, Greenblatt DJ, Granda BW, Giancarlo GM, Duan SX, Daily JP et al. Inhibition of human cytochrome P450 isoforms by nonnucleoside reverse transcriptase inhibitors. Journal of Clinical Pharmacology. 2001;41(1):85-91.
Von Moltke, L. L. ; Greenblatt, D. J. ; Granda, B. W. ; Giancarlo, G. M. ; Duan, S. X. ; Daily, Johanna P. ; Harmatz, J. S. ; Shader, R. I. / Inhibition of human cytochrome P450 isoforms by nonnucleoside reverse transcriptase inhibitors. In: Journal of Clinical Pharmacology. 2001 ; Vol. 41, No. 1. pp. 85-91.
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