• Support Care Cancer · Mar 2007

    Review

    The pharmacological importance of cytochrome CYP3A4 in the palliation of symptoms: review and recommendations for avoiding adverse drug interactions.

    • Abdo Haddad, Mellar Davis, and Ruth Lagman.
    • Palliative Medicine Fellowship Faculty, The Harry R. Horvitz Center for Palliative Medicine, Cleveland Clinic Taussig Cancer Center, Cleveland, OH 44195, USA.
    • Support Care Cancer. 2007 Mar 1; 15 (3): 251-7.

    BackgroundAdverse drug interactions are major causes of morbidity, hospitalizations, and mortality. The greatest risk of drug interactions occurs through in the cytochrome system. CYP3A4, the most prevalent cytochrome, accounts for 30-50% of drugs metabolized through type I enzymes.Materials And MethodsPalliative patients received medications for symptoms and co-morbidities, many of which are substrate, inhibitors, or promoters of CYP3A4 activity and expression. A literature review on CYP3A4 was performed pertinent to palliative medicine.DiscussionIn this state of the art review, we discuss the CYP3A4 genetics, and kinetics and common medications, which are substrates or inhibitor/promoters of CYP3A4.ConclusionWe made some recommendations for drug choices to avoid clinically important drug interaction.

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