Table 5.
Examples of potential consequences of phenoconversion | |
---|---|
Phenoconversion of CYP isoform | Increased toxicity of parent drug and/or decreased effect of the prodrugs |
CYP2C9 | Increased sensitivity to warfarin |
Phenytoin-induced neurotoxicity | |
Candesartan-induced hypotension | |
Decreased efficacy of losartan? | |
Sulphonylurea-induced hypoglycaemia? | |
CYP2C19 | Decreased therapeutic effect of clopidogrel |
Diminished antimyeloma efficacy of thalidomide | |
Decreased likelihood of antiviral response to nelfinavir | |
CYP2D6 | Decreased analgesic effect from codeine, tramadol and oxycodone |
Perhexiline-induced toxicity (e.g. neuropathy) | |
Decreased therapeutic effect of tamoxifen | |
Extrapyramidal symptoms from perphenazine | |
Increased β-blockade from metoprolol | |
Increased risk of dizziness from carvedilol |
[Compiled from literature review.]