However, at least for clopidogrel as a CYP 2C19
substrate, patients who are carriers for *2 or *3 have higher incidence of adverse cardiac events after percutaneous coronary angioplasty; therefore, they should not be listed as EMs.
The maximum recommended dose for patients with hepatic impairment, who are older than 60 years, who are CYP 2C19
poor metabolizers, or who are taking cimetidine is 20 mg/day because each of these factors can increase blood levels of citalopram, thus increasing the risk of QT interval prolongation and torsades de points.
In other words, these drugs impair the activity of CYP 2C19
He further said "that recent studies published in the New England Journal of Medicine indicated that about 30% of the patients had at least one CYP 2C19
reduced function genetic variant".
Five distinct human cytochromes mediate amitriptyline N-demethylation in vitro: dominance of CYP 2C19
0 1-2 well (pmol) Krebs-Heinslet Buffer 100 mM None 25 mM Pluronic F68 None None None Substrate CEC Coumarin MFC Concentration 5 mM 3 [micro]M 75 mM Source Ultrafine Sigma- Sigma- Chemicals Aldrich Aldrich Metabolite CHC 7-HC HFC Source Molecular Sigma- Gentest Probes Aldrich Inhibitor positive control Furafylline Tranyl- Sulfa- cypromine phenazole Concentration 100 [micro]M 100 [micro]M 100 [micro]M Source Ultrafine Sigma- Ultrafine Chemicals Aldrich Chemicals Incubation time 30 min 15 min 45 min Excitation wavelength 410 390 410 Emission wavelength 460 460 538 CYP 2C19
2D6 Amount Enzyme/ 0.