Selectivity - Which CYP Isozymes?

Indinavir inhibits Ritonavir inhibits

CYP3A4 CYP3A4, 2D6, 2C9, etc.

CYP3A4

PIS, NNRTIs

Benzodiazepines

Macrolides

Antifungals

Anticonvulsants

CYP2D6

Antidepressants

Codeine

CYP1A2

Theophylline

CYP2C9

Diclofenac

Flurbiprofen

Ibuprofen

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• Most protease inhibitors and NNRTIs primarily affect CYP3A4.

• On the other hand, ritonavir inhibits many cytochrome P450 isoenzymes including CYP3A, CYP2D6, CYP2C9, CYP2C19 and others.

• Therefore, ritonavir has the potential to interact with many more classes of agents which are metabolized via similar routes.