去甲替林与特比萘芬之间的药代动力学相互作用。
Pharmacokinetic interaction between nortriptyline and terbinafine.
作者信息
Van Der Kuy P-Hugo M, Van Den Heuvel Harrie A, Kempen Rob W, Vanmolkot Leo M L
机构信息
Department of Clinical Pharmacy and Toxicology, Academic Hospital Maastricht, Netherlands.
出版信息
Ann Pharmacother. 2002 Nov;36(11):1712-4. doi: 10.1345/aph.1C083.
OBJECTIVE
To clarify the mechanism of interaction between nortriptyline and terbinafine.
CASE SUMMARY
Nortriptyline intoxication secondary to terbinafine treatment was observed in a woman with a major depressive disorder. This is the second report of this interaction. A rechallenge was performed during which serum concentrations were measured of nortriptyline and the 2 hydroxy metabolites. To document the case, genotyping of CYP2D6 was also performed.
DISCUSSION
Metabolism by CYP2D6 is of major importance for the hydroxylation of nortriptyline, making it susceptible to competitive inhibition by terbinafine.
CONCLUSIONS
The pharmacokinetic interaction between nortriptyline and terbinafine is probably due to inhibition of CYP2D6 of the nortriptyline metabolism by terbinafine. The interaction is not restricted to a subpopulation, but may occur even in persons without deviations in CYP2D6.
目的
阐明去甲替林与特比萘芬之间的相互作用机制。
病例摘要
在一名患有重度抑郁症的女性中观察到因特比萘芬治疗继发的去甲替林中毒。这是该相互作用的第二例报告。进行了再次激发试验，在此期间测定了去甲替林及其2-羟基代谢物的血清浓度。为记录该病例，还进行了CYP2D6基因分型。
讨论
CYP2D6介导的代谢对于去甲替林的羟基化至关重要，使其易受特比萘芬的竞争性抑制。
结论
去甲替林与特比萘芬之间的药代动力学相互作用可能是由于特比萘芬抑制了去甲替林代谢的CYP2D6。这种相互作用并不局限于特定亚群，即使在CYP2D6无异常的个体中也可能发生。
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