title: Cytochrome P450-mediated cardiovascular drug interactions.
abstract: BACKGROUND
  There are numerous drug-drug interactions (DDIs) related to cardiovascular medications and many of these are mediated via the cytochrome P450 (CYP) system. Some of these may lead to serious adverse events and it is, therefore, essential that clinicians are aware of the important interactions that occur.
  
  
  METHODS
  An extensive literature search was performed to analyze the CYP-mediated cardiovascular DDIs that lead to a loss of efficacy or potential toxicity. Cardiovascular drugs may be victims or act as perpetrators of DDIs. The paper analyzes CYP-mediated drug interactions concerning anticoagulants, antiplatelet agents, antiarrhythmics, β-blockers, calcium antagonists, antihypertensive medications, lipid-lowering drugs and oral antidiabetic agents.
  
  
  CONCLUSIONS
  Cardiovascular DDIs involving the CYP system are numerous. Additionally, the spectrum of drugs prescribed is constantly changing, particularly with cardiovascular diseases and it is not necessarily the case that drugs that had shown safety earlier will always show safety. Clinicians are encouraged to develop their knowledge of CYP-mediated DDIs so that they can choose safe drug combination regimens, adjust drug dosages appropriately and conduct therapeutic drug monitoring for drugs with narrow therapeutic indices.
authors.affiliation: University of Liège, Division of Diabetes, Nutrition and Metabolic Disorders, Division of Clinical Pharmacology, Department of Medicine, CHU Liege, Belgium. andre.scheen@chu.ulg.ac.be
authors.forename: André J
authors.initials: AJ
authors.lastname: Scheen
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000378:metabolism / Q000494:pharmacology / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000378:metabolism / Q000494:pharmacology / Q000627:therapeutic use; D000925:Anticoagulants / Q000378:metabolism / Q000494:pharmacology / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000378:metabolism / Q000494:pharmacology / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000378:metabolism / Q000494:pharmacology / Q000627:therapeutic use; D002317:Cardiovascular Agents / Q000378:metabolism / Q000494:pharmacology* / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D003577:Cytochrome P-450 Enzyme System / Q000378:metabolism / Q000502:physiology*; D004347:Drug Interactions / Q000502:physiology*; D016903:Drug Monitoring; D006801:Humans; D000960:Hypolipidemic Agents / Q000378:metabolism / Q000494:pharmacology / Q000627:therapeutic use; D010975:Platelet Aggregation Inhibitors / Q000378:metabolism / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D000319:Adrenergic beta-Antagonists; D000889:Anti-Arrhythmia Agents; D000925:Anticoagulants; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D002317:Cardiovascular Agents; D000960:Hypolipidemic Agents; D010975:Platelet Aggregation Inhibitors; D003577:Cytochrome P-450 Enzyme System