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Flockhart Table ™

P450 Drug Interaction Table SUBSTRATES
1A2	2B6	2C8	2C9	2C19	2D6	2E1	3A4,5,7
amitriptyline caffeine² clomipramine clozapine cyclobenzaprine duloxetine estradiol fluvoxamine haloperidol imipramine N-DeMe mexiletine nabumetone naproxen olanzapine ondansetron phenacetin¹→ acetaminophen →NAPQI propranolol riluzole ropivacaine tacrine² theophylline² tizanidine triamterene verapamil (R)warfarin zileuton zolmitriptan	artemisinin bupropion¹ cyclophosphamide efavirenz¹ ifosphamide ketamine meperidine methadone nevirapine propafol selegiline sorafenib	amodiaquine² cerivastatin paclitaxel repaglinide sorafenib torsemide	NSAIDs: diclofenac¹ ibuprofen lornoxicam meloxicam S-naproxen→Nor piroxicam suprofen Oral Hypoglycemic Agents: tolbutamide¹ glipizide Angiotensin II Blockers: losartan irbesartan Sulfonylureas: glyburide glibenclamide glipizide glimepiride tolbutamide amitriptyline celecoxib fluoxetine fluvastatin glyburide nateglinide phenytoin-4-OH2 rosiglitazone tamoxifen torsemide valproic acid S-warfarin¹ zakirlukast	PPIs: esomeprazole lansoprazole omeprazole2 pantoprazole Anti-epileptics: diazepam→Nor phenytoin(O) S-mephenytoin¹ phenobarbitone amitriptyline carisoprodol citalopram chloramphenicol clomipramine clopidogrel cyclophosphamide hexobarbital imipramine N-DeME indomethacin labetalol R-mephobarbital moclobemide nelfinavir nilutamide primidone progesterone proguanil propranolol teniposide R-warfarin→8-OH voriconazole	tamoxifen: TAMOXIFEN GUIDE Beta Blockers: carvedilol S-metoprolol propafenone timolol Antidepressants: amitriptyline clomipramine desipramine fluoxetine imipramine paroxetine venlafaxine Antipsychotics: haloperidol perphenazine risperidone→9-OH thioridazine zuclopenthixol alprenolol amphetamine aripiprazole atomoxetine bufuralol¹ chlorpheniramine chlorpromazine clonidine codeine (→O-desMe) debrisoquine² dexfenfluramine dextromethorphan¹ donepezil duloxetine encainide flecainide fluvoxamine lidocaine metoclopramide methoxyamphetamine mexiletine minaprine nebivolol nortriptyline ondansetron oxycodone perhexiline phenacetin phenformin promethazine propafenone propranolol risperidone sparteine tramadol	Anesthetics: enflurane halothane isoflurane methoxyflurane sevoflurane acetaminophen→NAPQI aniline2 benzene chlorzoxazone1 ethanol N,N-dimethylformamide theophylline→8-OH	Macrolide antibiotics: clarithromycin erythromycin² (not 3A5) NOT azithromycin telithromycin Anti-arrhythmics: quinidine→3-OH (not 3A5) Benzodiazepines: alprazolam diazepam→3OH midazolam¹ triazolam² Immune Modulators: cyclosporine tacrolimus (FK506) HIV Antivirals: indinavir nelfinavir ritonavir saquinavir Prokinetic: cisapride Antihistamines: astemizole chlorpheniramine terfenadine² Calcium Channel Blockers: amlodipine diltiazem felodipine lercanidipine nifedipine² nisoldipine nitrendipine verapamil HMG CoA Reductase Inhibitors: atorvastatin cerivastatin lovastatin NOT pravastatin NOT rosuvastatin simvastatin Steroid 6beta-OH: estradiol hydrocortisone progesterone testosterone¹ Miscellaneous: alfentanil aprepitant aripiprazole boceprevir buspirone carbamazepine cafergot caffeine→TMU cilostazol cocaine codeine-N-demethylation dapsone dexamethasone dextromethorphan² docetaxel domperidone eplerenone fentanyl finasteride gleevec haloperidol irinotecan LAAM lidocaine methadone nateglinide nevirapine ondansetron pimozide propranolol quetiapine quinine risperidone romidepsin salmeterol sildenafil sirolimus sorafenib sunitinib tamoxifen taxol telaprevir terfenadine torisel trazodone vemurafenib vincristine zaleplon ziprasidone zolpidem
INHIBITORS
Inhibitors compete with other drugs for a particular enzyme thus affecting the optimal level of metabolism of the substrate drug which in many cases affect the individual's response to that particular medication, e.g. making it ineffective. A Strong inhibitor is one that causes a > 5-fold increase in the plasma AUC values or more than 80% decrease in clearance. A Moderate inhibitor is one that causes a > 2-fold increase in the plasma AUC values or 50-80% decrease in clearance. A Weak inhibitor is one that causes a > 1.25-fold but < 2-fold increase in the plasma AUC values or 20-50% decrease in clearance. FDA preferred¹ and acceptable² inhibitors for in vitro experiments.*
1A2	2B6	2C8	2C9	2C19	2D6	2E1	3A4,5,7
fluvoxamine ciprofloxacin cimetidine amiodarone efavirenz fluoroquinolones fluvoxamine furafylline¹ interferon methoxsalen mibefradil ticlopidine	clopidogrel thiotepa ticlopidine² voriconazole	gemfibrozil² trimethoprim² glitazones montelukast¹ quercetin¹	fluconazole² amiodarone efavirenz fenofibrate fluconazole fluvastatin fluvoxamine² isoniazid lovastatin metronidazole paroxetine phenylbutazone probenicid sertraline sulfamethoxazole sulfaphenazole¹ teniposide voriconazole zafirlukast	PPIs: esomeprazole lansoprazole omeprazole2 pantoprazole Other: chloramphenicol cimetidine felbamate fluoxetine fluvoxamine indomethacin isoniazid ketoconazole modafinil oral contraceptives oxcarbazepine probenicid ticlopidine2 topiramate voriconazole	bupropion cinacalcet fluoxetine paroxetine quinidine¹ duloxetine sertraline terbinafine amiodarone cimetidine celecoxib chlorpheniramine chlorpromazine citalopram clemastine clomipramine cocaine diphenhydramine doxepin doxorubicin escitalopram halofantrine haloperidol histamine H1 receptor antagonists hydroxyzine levomepromazine methadone metoclopramide mibefradil midodrine moclobemide perphenazine promethazine ranitidine reduced-haloperidol ritonavir ticlopidine tripelennamine	diethyl-dithiocarbamate² disulfiram	HIV Antivirals: indinavir nelfinavir ritonavir clarithromycin itraconazole¹ ketoconazole nefazodone saquinavir suboxone telithromycin aprepitant erythromycin fluconazole grapefruit juice verapamil² diltiazem cimetidine amiodarone NOT azithromycin chloramphenicol boceprevir ciprofloxacin delaviridine diethyl-dithiocarbamate fluvoxamine gestodene imatinib mibefradil mifepristone norfloxacin norfluoxetine starfruit telaprevir voriconazole
INDUCERS
1A2	2B6	2C8	2C9	2C19	2D6	2E1	3A4,5,7
broccoli brussel sprouts carbamazepine char-grilled meat insulin methylcholanthrene¹ modafinil nafcillin beta-naphthoflavone¹ omeprazole¹ rifampin tobacco	artemisinin carbamazepine efavirenz nevirapine phenobarbital phenytoin rifampin	rifampin¹	carbamazepine enzalutamide nevirapine phenobarbital rifampin secobarbital St. John's Wort	carbamazepine efavirenz enzalutamide norethindrone NOT pentobarbital prednisone rifampicin¹ ritonavir St. John's Wort	dexamethasone rifampin	ethanol isoniazid	HIV Antivirals: efavirenz nevirapine barbiturates carbamazepine enzalutamide glucocorticoids modafinil oxcarbazepine phenobarbital² phenytoin² pioglitazone rifabutin rifampin¹ St. John's Wort troglitazone¹

The Flockhart Table™ is © 2016 by The Trustees of Indiana University. All rights reserved.

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