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Flockhart Table ™

P450 Drug Interactions

Abbreviated "Clinically Relevant" Table 
SUBSTRATES
1A2 2B6 2C8 2C9 2C19 2D6 2E1 3A4,5,7
clozapine artemisinin paclitaxel NSAIDs: PPIs: Beta Blockers: Anesthetics: Macrolide
cyclobenzaprine bupropion1 torsemide diclofenac esomeprazole carvedilol enflurane antibiotics:
duloxetine cyclophosphamideamodiaquine 2 ibuprofen lansoprazole S-metoprolol halothane clarithromycin
fluvoxamine efavirenz 1 cerivastatin naproxen omeprazole propafenone isoflurane erythromycin (not
haloperidol ifosfamide repaglinide piroxicam pantoprazole timolol methoxyflurane 3A5)
imipramine ketamine sevoflurane NOT azithromycin
mexiletine meperidine Oral Anti-epileptics: Antidepressants: telithromycin
nabumetone methadone Hypoglycemics: diazepam amitriptyline Others:
naproxen nevirapine tolbutamide phenytoin clomipramine acetaminophen→NAPQI Anti-arrhythmics:
olanzapine propofol glipizide phenobarbitone desipramine aniline quinidine→3-OH
riluzole selegiline glyburide duloxetine benzene (not 3A5)
tacrine2   Others: fluoxetine chlorzoxazone
theophylline Angiotensin II amitriptyline imipramine ethanol Benzodiazepines:
tizanidine Blockers: carisoprodol paroxetine N,N-dimethyl formamide alprazolam
triamterene losartan citalopram theophylline→8-OH diazepam→3OH
zileuton irbesartan clomipramine Antipsychotics: midazolam
zolmitriptan clopidogrel haloperidol triazolam
  Others: cyclophosphamiderisperidone
celecoxib imipramine thioridazine Immune
fluvastatin labetalol Modulators:
phenytoin proguanil Others: cyclosporine
rosiglitazone voriconazole aripiprazole tacrolimus (FK506)
torsemide atomoxetine sirolimus
valproic acid codeine
warfarin dextromethorphan HIV Antivirals:
zafirlukast doxepine indinavir

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Flockhart Table ™ Indiana University, School of Medicine, Department of Medicine

flecainide ritonavir
mexiletine saquinavir
ondansetron nevirapine
oxycodone
risperidone Prokinetics:
tamoxifen cisapride
TAMOXIFEN
GUIDE Antihistamines:
tramadol astemizole
venlafaxine chlorpheniramine

Calcium Channel
Blockers:
amlodipine
diltiazem
felodipine
nifedipine
nisoldipine
nitrendipine
verapamil

HMG CoA
Reductase
Inhibitors:
atorvastatin
lovastatin
NOT pravastatin
NOT rosuvastatin
simvastatin

PDE-5 Inhibitors:
sildenafil
tadalafil
vardenafil

Others:
alfentanyl
aripiprazole
boceprevir
buspirone
carbamazepine
gleevec
haloperidol
pimozide
quinine
tamoxifen
telaprevir
trazodone
vincristine

INHIBITORS

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Flockhart Table ™ Indiana University, School of Medicine, Department of Medicine

A Strong inhibitor is one that causes a > 5-fold increase in the plasma AUC values or more than 80% decrease in clearance.
A Moderate inhibitor is one that causes a > 2-fold increase in the plasma AUC values or 50-80% decrease in clearance.
A Weak inhibitor is one that causes a > 1.25-fold but < 2-fold increase in the plasma AUC values or 20-50% decrease in clearance.

 
1A2 2B6 2C8 2C9 2C19 2D6 2E1 3A4,5,7
amiodarone clopidogrel gemfibrozil amiodarone cimetidine bupropion disulfiram HIV Antivirals:
cimetidine thiotepa montelukast1 efavirenz esomeprazole fluoxetine indinavir
efavirenz ticlopidine2 fluconazole 2 felbamate paroxetine nelfinavir
fluoroquinolonesvoriconazole isoniazid fluoxetine quinidine 1 ritonavir
fluvoxamine1   metronidazole fluvoxamine
ticlopidine paroxetine isoniazid duloxetine clarithromycin
  sulfamethoxazole ketoconazole itraconazole
voriconazole lansoprazole amiodarone ketoconazole
omeprazole cimetidine
nefazodone
oral contraceptives erythromycin
aripiprazole
pantoprazole grapefruit juice
diphenhydramine
ticlopidine2 verapamil 2
chlorpheniramine
voriconazole  
clomipramine
 suboxone
doxepin
diltiazem
haloperidol
methadone
cimetidine
ritonavir
terbinafine
amiodarone
NOT azithromycin
fluvoxamine
troleandomycin
voriconazole

INDUCERS
1A2 2B6 2C8 2C9 2C19 2D6 2E1 3A4,5,7
carbamazepine artemisinin   carbamazepine efavirenz   ethanol carbamazepine
chargrilled meat carbamazepine nevirapine rifampin isoniazid efavirenz
rifampin efavirenz phenobarbital ritonavir nevirapine
tobacco nevirapine rifampin St. John's Wort phenobarbital
  phenobarbital St. John's Wort phenytoin
phenytoin pioglitazone
rifampin rifabutin
rifampin
St. John's Wort
troglitazone

GENETICS
1A2 2B6 2C8 2C9 2C19 2D6 2E1 3A4,5,7
Chr Chr Chr Chr Chr Chr 22 Chr Chr
      Haplotypes: Haplotypes: Haplotypes:    
*2=PM *2=PM (99% in *2=EM (similar to
*3=PM Asians) WT)
*3=PM (87% in *3=PM (truncates
Whites) protein)

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Flockhart Table ™ Indiana University, School of Medicine, Department of Medicine

*4=PM (non-
functional)
*5=PM (whole
gene del.)
*6=PM (truncates
protein)
*9=IM/EM
(reduces func.)
*10=IM (reduces
func.)
*17=IM (reduces
func.)
*29=IM (reduces
func.)
*41=IM (reduces
func.)
Metabolizer
Phenotypes:
PM = Poor
IM =
Intermediate
EM = Extensive
UM = Ultrarapid
The Flockhart Table™ is © 2016 by The Trustees of Indiana University. All rights reserved.

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