LymeNet Flash: P450 Drug interactions with Lexapro/SSRI's

This is topic P450 Drug interactions with Lexapro/SSRI's in forum Medical Questions at LymeNet Flash.

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Posted by auntybiotic1499 (Member # 2998) on :

GIGI or anyone with pharmacy knowledge,

Can anyone tell me from looking at the Drug interaction chatrs of the P450 Cytochrome system.....what can be taken with Lexapro that will NOT raise the levels of the lexapro.

I need meds that do not go thru the CyP2c19
or the 3A4 or the Cy6 pathways of the liver.

I need to know a safe over the counter pain med, tylenol?? I know Motrin and Asprin are NO NO's!

How about a anti anxiety, I know Xaxax is a NO No!

How about a sleeping aid, I know that Melotonin is a NO NO with the SSRI as well as MIlk Thistle is a definate NO No with all SSRI's.

If anyone understands the charts can you please e-mail me and I can take your recommendations to her doctor to verify.
Drug interactions are difficult to understand with the inhibitors as well as the inducers.If you go on Prozactruth.com and press drug interactions you will find links to three excellent P450 charts.

Thanks,
aunty

Posted by bpeck (Member # 3235) on :

If you have the specific P450 pathway you
know the drug uses, then you need to research the drug you want to combine with it.. and the inter-actions can be any one of 3 - or ** all ** three ( the interations are: Inhibitor, inducer or substrate).

You can search using those key words with pharmakinetics or (if it's a drug as oppossed to a supplement) you can contact the drug company.

Flockhart has the best P450 chart I know of, and it's updated regularily.

Barb

Posted by auntybiotic1499 (Member # 2998) on :

B Peck,

Can you explain the differences between the subrate, inhibitor and inducer. That is what I am having trouble grasping. If Lexapro is a inducer of the C6 pathway and Xanax is also using that pathway what happens? Are levels of Lexapro raise or levels of xanax raised. No place explained this process.
aunty

Posted by TheCrimeOfLyme (Member # 4019) on :

All you need to do is check the drug interactions, and it will show where the P450 , if so, is being inhibited by a macrolide, etc.

Biaxin and Zoloft? Serotonin syndrome
Biaxin and most anything that uses the P450 ? Serotonin syndrome. End result? Can be death.

MOST ANBIOTICS AND ANTIDEPRESSANTS ARE NOT TO BE TAKEN TOGETHER.

Im done preaching that though. Ive been for a year, and not a soul has listened./

Posted by Kira (Member # 2676) on :

Hi there,

Can you share what test you did, or how you came to learn that these particular liver enzyme pathways or problematic as far you being able to metabolize certain meds...

I highly suspect this in myself because I always get toxic when given certain meds...but docs never seem to believe me... Sure would help if I had "proof" so I could avoid having to prove to them the hard way that I can not take certain meds!!

Kira

Posted by Recipegirl05 (Member # 6729) on :

Hi Auntybiotic1499,

Here's the link to the Flockhart Chart. Thanks to bpeck. Yes, it's awesome.

http://medicine.iupui.edu/flockhart/table.htm

Kira----

Also, if you go to www.drugdigest.org
you can click on drug interactions just like COL said.

Then you place the 2 drugs in the box & press enter.

You'll get a good explanation of why the interaction happens.

Hope that helps.

Take Care,
Jan