Table 4.

Mechanisms of elimination of anxiolytic drugs, their active metabolites and their effects on metabolism enzymes and P-gp.

Anxiolytics	Maine Route(s) of Elimination	Possible Mechanisms of Interactions
		Inducing or Inhibiting Effects on CYP, UGT and P-gp	Main Active Metabolite
Diazepam	CYP3A4 and CYP2C19 Conjugation of its active metabolites with glucuronic acid	-	Desmethyldiazepam, oxazepam and temazepam
Chlordiazepoxide	CYP3A4	-	Desmethylchlordiazepoxide, demoxepam, desmethyldiazepam and oxazepam
Oxazepam	Conjugation with glucuronic acid	-	-
Clorazepate	CYP3A4	-	Nordiazepam (further metabolized by hydroxylation to oxazepam)
Lorazepam	Conjugation with glucuronic acid	-	-
Alprazolam	CYP3A4	-	-
Buspirone	CYP3A4	-	1-(2-pyrimidinyl)-piperazine

Note: Anxiolytics are listed in the same order they appear in the ATC system. For a source of references, see the SmPC or PI of each anxiolytic.

For abbreviations, see Table 2.