In vivo function tests of hepatic drug-oxidizing capacity in patients with liver disease

Aminopyrine, antipyrine and trimethadione have been widely used for some time as probe drugs to assess non-selective P450 liver function. They have proved useful in evaluating pre- and post-operative liver function when performing surgery, transplantations, etc., in addition to a general evaluation of liver function and drug interactions. Progress has recently been made both in these non-selective P450 function tests and in the analysis of drug-metabolizing enzymes at a molecular level, which has resulted in more selective P450 function tests. The caffeine (CYP1 A2), chlorzoxazone (CYP2E1), lidocaine (CYP3 A) and midazolam (CYP3 A) function tests and the erythromycin breath test (CYP3 A) are currently being used as specific probes. The future use of these tests needs to be discussed in terms of potential clinical implications.