TABLE 6

Summary of predictions of drug-drug interactions for CYP2C19


Inhibiting Drug

IC50a

fu

Affected Drug

Predicted Magnitude of Drug Interaction

Actual Drug Interaction
[I] = Csys
[I] = fu × Csys
[I] = Chep,inlet(est)
[I] = fu × Chep,inlet(est)
μM
Citalopram >300 0.20 Mephenytoin 1.00 1.00 1.01 1.00 1.00
Clarithromycin >300 0.30 Omeprazole 1.00 1.00 1.04 1.01 2.12
Disulfiram 5.5 0.04 Mephenytoin 1.00 1.00 6.08 1.20 1.00
Fluconazole 5.8 0.89 Omeprazole 3.93 3.73 4.47 4.28 6.29
Fluvoxamine 0.35 0.23 Mephenytoin 2.67 1.38 35.2 8.87 9.89
Ketoconazole 9.4 0.01 Omeprazole 1.54 1.01 2.10 1.01 1.36
Moclobemide 160 0.50 Omeprazole 1.14 1.07 1.37 1.19 1.96
Paroxetine 22 0.05 Mephenytoin 1.04 1.00 1.50 1.02 1.00
Risperidone 290 0.11 Mephenytoin 1.00 1.00 1.00 1.00 1.09
Roxithromycin >300 0.14 Omeprazole 1.04 1.01 1.08 1.01 1.31
Ticlopidineb 0.78 0.02 Omeprazole 4.37 1.13 7.01 2.01 2.39
Troleandomycin
>300
0.15c
Omeprazole
1.01
1.00
1.05
1.01
1.26
  • a Used a value of IC50 = 1000 μM for those drugs for which the measured value was greater than 300 μM

  • b Ticlopidine is a known mechanism-based in activator of CYP2C19

  • c Used an estimated fraction unbound value for troleandomycin of 0.15