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CYP2C8-Mediated Drug-Drug Interactions and the Factors Influencing the Interaction Magnitude
Ling-Ling Zhu1, Ling-Yan Yu2, Yan-Hong Wang2
1VIP Care and Geriatric Ward, Division of Nursing, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People's Republic of China.
Cytochrome P450 (CYP) 2C8 is an important enzyme for drug metabolism, but its drug-drug interactions (DDIs) are often overlooked. This review details CYP2C8 substrates, inhibitors, inducers, and factors influencing DDI magnitude, crucial for safe medication use in older adults.
Area of Science:
- Pharmacology
- Drug Metabolism
- Clinical Pharmacy
Background:
- Older adults frequently have multiple health conditions, leading to polypharmacy.
- Cytochrome P450 (CYP) 2C8 plays a key role in metabolizing numerous drugs.
- CYP2C8-related drug-drug interactions (DDIs) are less recognized clinically compared to major CYP enzymes.
Purpose of the Study:
- To review CYP2C8-mediated DDIs.
- To summarize factors influencing the magnitude of these interactions.
- To enhance clinical awareness of CYP2C8 DDIs for safer medication management in the elderly.
Main Methods:
- Literature search conducted in PubMed, Web of Science, and Embase up to January 2025.
- Search terms included CYP2C8 and drug interactions.
- Study selection followed PRISMA guidelines, with 57 studies meeting inclusion criteria.
Main Results:
- Identified 5 CYP2C8 inducers, 53 inhibitors, and 32 substrates.
- Illustrated typical DDIs using in vitro-in vivo extrapolation.
- Detailed numerous factors influencing DDI magnitude, including genetic polymorphisms, organ function, and drug properties.
Conclusions:
- CYP2C8 is a significant but underappreciated drug-metabolizing enzyme (DME).
- This review offers a comprehensive summary of CYP2C8 substrates, perpetrators, DDIs, and influencing factors.
- Recognizing these interactions is vital for improving medication safety in older adults.
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