Inhibition and induction of CYP enzymes in humans: an update

Arch Toxicol. 2020 Nov;94(11):3671-3722. doi: 10.1007/s00204-020-02936-7. Epub 2020 Oct 27.

Abstract

The cytochrome P450 (CYP) enzyme family is the most important enzyme system catalyzing the phase 1 metabolism of pharmaceuticals and other xenobiotics such as herbal remedies and toxic compounds in the environment. The inhibition and induction of CYPs are major mechanisms causing pharmacokinetic drug-drug interactions. This review presents a comprehensive update on the inhibitors and inducers of the specific CYP enzymes in humans. The focus is on the more recent human in vitro and in vivo findings since the publication of our previous review on this topic in 2008. In addition to the general presentation of inhibitory drugs and inducers of human CYP enzymes by drugs, herbal remedies, and toxic compounds, an in-depth view on tyrosine-kinase inhibitors and antiretroviral HIV medications as victims and perpetrators of drug-drug interactions is provided as examples of the current trends in the field. Also, a concise overview of the mechanisms of CYP induction is presented to aid the understanding of the induction phenomena.

Keywords: Cytochrome P450; Drug–drug interaction; Environmental toxicants; Herbal remedies; Induction; Inhibition.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Anti-Retroviral Agents / antagonists & inhibitors
  • Anti-Retroviral Agents / pharmacology*
  • Antineoplastic Agents / pharmacology
  • Cytochrome P-450 Enzyme Inducers / metabolism*
  • Cytochrome P-450 Enzyme Inhibitors / metabolism*
  • Cytochrome P-450 Enzyme System / metabolism*
  • Drug Interactions
  • Humans
  • Protein-Tyrosine Kinases / antagonists & inhibitors*
  • Xenobiotics / metabolism*

Substances

  • Anti-Retroviral Agents
  • Antineoplastic Agents
  • Cytochrome P-450 Enzyme Inducers
  • Cytochrome P-450 Enzyme Inhibitors
  • Xenobiotics
  • Cytochrome P-450 Enzyme System
  • Protein-Tyrosine Kinases