Cytochrome p450 Interactions
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CYP enzyme mechanisms and mnemonics
Cytochrome P450 enzymes help metabolize many medications. A substrate is a drug processed by an enzyme; inhibitors and inducers can change that processing and alter exposure.
Explore individual enzymes
Go to CYP1A2 on ballicules.com · CYP2B6 · CYP2C9 · CYP2C19 · CYP2D6 · CYP3A4
The medication avatars on this page illustrate examples of substrates, inhibitors and inducers.
Substrates: medications an enzyme processes
Trazodone is a CYP3A4 substrate. Vortioxetine is an example where CYP2D6 metabolism is important. The two substrate avatars below distinguish these pathways.
Inhibitors: reduced enzyme activity
Inhibiting a metabolic pathway can raise exposure to a susceptible substrate. The outcome depends on the drug, alternative pathways and whether an active metabolite is needed.
Fluoxetine strongly inhibits CYP2D6. Fluvoxamine strongly inhibits CYP1A2. Their avatars provide distinct enzyme-specific cues.
Inducers: increased enzyme activity
Induction can increase metabolic capacity and lower exposure to susceptible drugs. It usually develops and resolves more slowly than inhibition because enzyme production changes.
Carbamazepine and rifampin are examples of strong CYP3A4 inducers. The “shredder” avatars cue increased drug breakdown.
Enzyme-specific differences matter
CYP2D6 has no established clinical drug inducer, while CYP3A4 has many. Smoking can induce CYP1A2 through combustion products rather than nicotine. These differences make the exact pathway important.