CYP1A2 inHibition Examples including Clozapine-Fluvoxamine
Excerpt from Cafer's Mood Stabilizers and Antiepileptics CYP1A2 in H ibition Examples Ciprofloxacin, a moderate 1A2 in H ibitor, increases clozapine levels about 2-fold. Flu voxamine, a strong 1A2 in H ibitor, increases clozapine levels 3-fold on average, but up to 10-fold in some cases. Kinetic interactions can be more complicated than simply increasing/decreasing concentrations of victim substrates. Combining clozapine and fluvoxamine is hazardous, but can potentially be used for therapeutic advantage. Close monitoring of serum clozapine levels would be required. Norclozapine is the main metabolite of clozapine, formed by 1A2. When clozapine blood levels are reported, clozapine and metabolite (norclozapine) levels are provided separately. Through 1A2 in H ibition, Luvox increases the clozapine:norclozapine ratio . A H igher serum clozapine:norclozapine ratio is generally considered desirable*. Norclozapine...