cyp2d6
5 interactions related to cyp2d6
carvedilol + st. john's wort
Carvedilol is metabolized by CYP2D6, CYP2C9, CYP3A4, and CYP1A2, and is also a P-glycoprotein substrate. St. John's Wort potently induces several of these enzymes and P-gp, accelerating carvedilol clearance and reducing plasma levels, which can blunt its heart failure and antihypertensive effects.
fluoxetine + kava
Kava carries a documented risk of hepatotoxicity and produces CNS depression, and combining it with fluoxetine raises the risk of additive sedation and liver injury. Kava also inhibits CYP2D6 and CYP3A4, the enzymes that metabolize fluoxetine, which can elevate fluoxetine levels and side effects.
alcohol + codeine
Codeine combined with alcohol produces additive CNS and respiratory depression, with risk of fatal overdose particularly elevated in CYP2D6 ultra-rapid metabolizers who convert codeine to morphine rapidly. The combination also increases sedation, impaired judgment, and the risk of accidents.
cbd + beta-blockers
CBD inhibits several CYP450 enzymes (notably CYP3A4, CYP2C19, CYP2C9, CYP1A2) and may modestly inhibit CYP2D6. Beta-blockers such as metoprolol, propranolol, and carvedilol are metabolized via CYP2D6 (and CYP1A2 for propranolol), so co-use can raise beta-blocker plasma levels, with additive blood-pressure lowering and bradycardia.
nortriptyline + st. john's wort
St. John's wort induces CYP3A4 and CYP2D6, the enzymes responsible for metabolizing nortriptyline, reducing nortriptyline blood levels and antidepressant effect. The herb also adds serotonergic activity that may increase risk of serotonin syndrome.