Dr Alexis Garcia on the Role of CYP450 Enzymes in Drug Efficacy

Alexis Garcia, PharmD, senior director of business development at Tabula Rasa HealthCare, outlines how cytochrome P450 enzymes can impact medication efficacy in patients taking multiple drugs.

When medications are metabolized by the same enzymes, you run the risk of drug-drug interactions, said Alexis Garcia, PharmD, senior director of business development at Tabula Rasa HealthCare.


Can you explain the role of cytochrome P450 enzymes in adverse drug events and other outcomes?

So the cytochrome P450 (CYP450) family of enzymes are essential for the metabolism of many medications. And today about 80% to 90% of commonly prescribed medications are actually metabolized by this class of enzymes. And when you have so many medications that are metabolized by the same enzymes, you really run the risk of competition or drug-drug interactions that could occur at that metabolic pathway. And so if you have multiple medications competing for metabolism on any given enzyme, you really can ultimately impact the effectiveness of that medication or even the safety of that medication.

What different pharmaceutical classes are affected by this enzyme? Are some more impacted than others?

There's a lot of medications and medication drug classes that are affected by this family of enzymes. You have statins, beta blockers, a big one is antidepressants. And then also, grapefruit juice can impact the way medications are metabolized through this enzyme.

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