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CYP3A4

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> 50% of prescription drugs are 3A4 substrates—plenty of fish!

 

0% of individuals are 3A4 ultrarapid metabolizers. Less than 1% are poor metabolizers.

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Conclusion: 3A4 is the workhorse of CYP metabolism, accounting for 30% of hepatic CYP activity and 70% of CYP activity in the gut. Since > 50% of drugs are 3A4 substrates, think twice before prescribing strong 3A4 inhibitors or inducers.

CYP3A4 inhibitor visual mnemonic fish by Dr Jason Cafer MD
CYP3A4 inducers visual mnemonic by Dr Jason Cafer MD

3A4 inhibitors​

CYP3A4 inhbitors biaxin clarithromycin erythromycin nizoral ketoconazole sporanox itraconazole diflucan fluconazole by Dr Jason Cafer MD
CYP3A4 inhibitors from psychopharmacology book by Jason Cafer MD grapefruit juice, serzone nefazodone, darunavir ritonavir atazanavir cardizem diltiazem calan verapamil

3A4 inducers​

Teaching Slides - Cafers Antidepressants 3A4 inducers - dilantin phenytoin luminal phenobarbital primidone tegretol carbamazepine provigil modafinial nuvigil armodafinil rifampin efavirenz nevirapine st john's wort

3A4 substrates​

Benzodiazepines as CYP3A4 substrates - valium diazepam xanax alprazolam tranxene clorazepate prosom estazolam halcion triazolam librium chlordiazepoxide klonopin clonazepam versed midazolam by Dr Jason Cafer MD psychiatrist
CYP3A4 substrates - fish by Dr Jason Cafer MD - antipsychotics - latuda lurasidone caplyta lumateperone orap pimozide nuplazid pimavanserin vraylar cariprazine seroquel quetiapine abilify aripiprazole rexulti brexpiprazole visual mnemonics by Dr Jason Cafer MD
3A4 substrates fish by Dr Jason Cafer MD - buspar buspirone viibryd vilazodone suboxone buprenorphine ingrezza valbenazine dayvigo lemborexant belsomra suvorexant
CYP3A4 substrates fish by Dr Jason Cafer MD viagra sildenafil estrogens progestins cialis tadalafil vardenafil levitra stendra avanafil Addyi flibanserin
Cafer's Psychopharmacology CYP3A4 substrates statins lipitor atorvastatin zocor simvastatin interactions
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