Kiley Cristin A, Cragin Douglas J, Roth Bernard J
Department of Medicine, Madigan Army Medical Center, Tacoma, WA 98431-1100, USA.
South Med J. 2007 Apr;100(4):400-2. doi: 10.1097/SMJ.0b013e31802f34ea.
Omeprazole is a commonly prescribed inhibitor of the gastric proton pump and has numerous indications in the treatment of gastrointestinal diseases. It is primarily metabolized through the CYP2C19 enzyme, a member of the P450 mixed-function oxidase group, although a minor pathway of metabolism is through CYP3A4, another P450 enzyme. Digoxin is primarily metabolized outside the P450 system, but a minor pathway of metabolism is by CYP3A4. To our knowledge, this is the first known case of digoxin toxicity associated with omeprazole. The possible pathways for such an interaction are reviewed, including increased stomach absorption, p-glycoprotein activity and interactions in the P450 system.
奥美拉唑是一种常用的胃质子泵抑制剂，在胃肠道疾病治疗中有多种适应证。它主要通过细胞色素P450混合功能氧化酶家族的CYP2C19酶进行代谢，不过其代谢的次要途径是通过另一种P450酶CYP3A4。地高辛主要在细胞色素P450系统外进行代谢，但其代谢的次要途径是通过CYP3A4。据我们所知，这是首例已知的与奥美拉唑相关的地高辛中毒病例。本文回顾了这种相互作用的可能途径，包括胃吸收增加、P-糖蛋白活性以及在细胞色素P450系统中的相互作用。
