> For the complete documentation index, see [llms.txt](https://thisispiggy.gitbook.io/my-wiki/llms.txt). Markdown versions of documentation pages are available by appending `.md` to page URLs; this page is available as [Markdown](https://thisispiggy.gitbook.io/my-wiki/01-step-1/pharm/cyp450.md).

# CYP 450

![](https://f001.backblazeb2.com/file/wikiFiles/aJGCvBB.jpg)

* cyclosporine, macrolides, azoles are all inhibitors

## CYP450 Inducers

| Inducers        | Inhibitors             | Substrates                  |
| --------------- | ---------------------- | --------------------------- |
| St. John's Wort | Grapefruit Juice       | Warfarin                    |
| Carbamazepine   | Cimetidine             | Phenytoin                   |
| Phenytoin       | Erythromycin           | Theophylline                |
| Phenobarbital   | Ciprofloxacin          | Statin (except pravastatin) |
| Rifampin        | Azoles                 | Cyclophosphamide            |
| Griseofulvin    | Ritonavir              | zaleplon                    |
| Chronic EtOH    | Isoniazid              | zolpidem                    |
| Modafinil       | Bactrim/Metronidazolex | Benzodiazepine              |
|                 | Amiodarone             |                             |
|                 | Simprevir              |                             |
|                 | Diltiazem              |                             |
|                 | Fluoroquinolones       |                             |

![](https://i.imgur.com/Azzuus7.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/LqYnSsO.jpg)

* Activated chrome bumper: barbiturates (e.g. phenobarbital) are potent inducers of the cytochrome P450 system

![](https://f001.backblazeb2.com/file/wikiFiles/uvHSCoF.jpg)

* Speeding chrome bumper: rifampin activated cytochrome P450

![](https://f001.backblazeb2.com/file/wikiFiles/CdlC4nD.jpg)

* Greased up chrome bumper: griseofulvin activates cytochrome P-450

## CYP450 Inhibitors

![](https://f001.backblazeb2.com/file/wikiFiles/pQUDQQu.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/x1Lu2Gg.jpg)

* Broken chrome bumper: cytochrome P-450 inhibition

![](https://f001.backblazeb2.com/file/wikiFiles/6VwAAW7.jpg)

![](https://f001.backblazeb2.com/file/wikiFiles/5pPeRbU.jpg)

* Broken chrome bumper: azole antifungals inhibit fungal cytochrome P-450 responsible for the conversion. Also SE because CYP 450

![](https://f001.backblazeb2.com/file/wikiFiles/8ftTVbk.jpg)

* Right on!: ritonovir has greatest cytochrome P-450 inhibitory effect and boosts concentration of other protease inhibitors

![](https://f001.backblazeb2.com/file/wikiFiles/uvHSCoF.jpg)

* Broken chrome bumper: INH inhibits cytochrome P450

![](https://f001.backblazeb2.com/file/wikiFiles/5XGsQLW.jpg)

* Vandalized chrome bumper: inhibition of cytochrome P450

![](https://f001.backblazeb2.com/file/wikiFiles/gRuqWDx.jpg)

* Broken chrome bumper: amiodarone inhibits the cytochrome P450 system

![](https://f001.backblazeb2.com/file/wikiFiles/NiLkunj.jpg)

* Broken chrome bumper: simeprevir inhibits cytochrome P450

## Substrates

![](https://f001.backblazeb2.com/file/wikiFiles/pQUDQQu.jpg)

![](https://i.imgur.com/MKkvyw8.jpg)

* chrome tank: all statins except for pravastatin are metabolized by cytochrome p450 (CYP-450) in the liver

![](https://i.imgur.com/bizBioe.jpg)

* Activating chrome bumper: cyclophosphamide is ACTIVATED by hepatic cytochrome P450 enzymes

![](https://f001.backblazeb2.com/file/wikiFiles/uVV1p3b.jpg)

* Liver spot: zaleplon and zolpidem are rapidly metabolized by the liver, P450 system 

![](https://i.imgur.com/ahGwgYm.jpg)

* CYP-450 chrome tank crushing warhead: warfarin is a substrate of cytochrome P-450 (drugs increase CYP activation increase warfarin metabolism) 

![](https://i.imgur.com/6PDfuOV.jpg)

* Chrome bumper hitting energy drinks: methylxanthines (e.g. theophylline) are metabolized by the cytochrome P-450 system