Cytochrome P450 InteractionsCYP2D6

Substrates = bioactivation by CYP2D6 All tricyclic antidepressants, e.g. Imipramine Amitriptyline etc. Most SSRIs (antidepressant), e.g. Fluoxetine Paroxetine Fluvoxamine Venlafaxine (SNRI antidepressant) Mianserin (tetracyclic antidepressant) Opioids Codeine into morphine Tramadol Oxycodone Antipsychotics, e.g. Haloperidol Risperidone Perphenazine Thioridazine Zuclopenthixol Iloperidone Aripiprazole Chlorpromazine Levomepromazine Remoxipride Minaprine (RIMA antidepressant) Tamoxifen (SERM) Beta-blockers Metoprolol Timolol Alprenolol Carvedilol Bufuralol Nebivolol Propranolol Debrisoquine (antihypertensive) Class I antiarrhythmics Flecainide Propafenone Encainide Mexiletine Lidocaine Sparteine Ondansetron (antiemetic) Donepezil (acetylcholinesterase inhibitor) Phenformin (antidiabetic) Tropisetron (5-HT3 receptor antagonist) Amphetamine (in ADHD, narcolepsy) Atomoxetine (in ADHD) Chlorphenamine (antihistamine) Dexfenfluramine (serotoninergic anorectic) Dextromethorphan (antitussive) into psychoactive dextrorphan Duloxetine (SNRI) Metoclopramide (dopamine antagonist) Methoxyamphetamine Perhexiline (antianginal agent) Phenacetin (analgesic) Promethazine (antihistamine antiemetic) Inhibitors Strong: SSRIs Fluoxetine Paroxetine Bupropion (non-SSRI antidepressant) Quinidine (class I antiarrhythmic agent) Cinacalcet (calcimimetic) Ritonavir (antiretroviral) Moderate Sertraline (SSRI) Duloxetine (SNRI Terbinafine (antifungal) Weak: Buprenorphine (in opioid addiction) Amiodarone (antiarrhythmic) Cimetidine (H2-receptor antagonist) Unspecified potency: Antipsychotics Haloperidol Perphenazine Thioridazine Zuclopenthixol Risperidone Chlorpromazine Bicalutamide Hyperforin (St. Johns Wort) Antihistamines (H1-receptor antagonists) Promethazine Chlorphenamine Diphenhydramine Hydroxyzine Tripelennamine Some SSRI antidepressants Citalopram Escitalopram Clemastine (antihistamine and anticholinergic) Celecoxib (NSAID) Clomipramine (tricyclic antidepressant) Cocaine (stimulant) Doxorubicin (chemotherapeutic) Metoclopramide (antiemetic, prokinetic) Methadone (analgesic and anti-addictive) Moclobemide (antidepressant) Ranitidine (H2-receptor antagonist) Doxepin (tricyclic antidepressant, anxiolytic) Halofantrine (in malaria) Levomepromazine (antipsychotic) Mibefradil (calcium channel blocker) Midodrine (1 agonist) Ticlopidine (antiplatelet) Inducers Dexamethasone (glucocorticoid) Rifampicin (bactericidal) Strong: Glutethimide (hypnotic sedative)