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Old 07-04-2019, 09:23 PM
johnt johnt is offline
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Join Date: Apr 2009
Location: Stafford, UK
Posts: 1,059
15 yr Member
johnt johnt is offline
Senior Member
 
Join Date: Apr 2009
Location: Stafford, UK
Posts: 1,059
15 yr Member
Default Some more CYP3A4 inhibitors

People following the grapefruit thread started by Albert are familiar with the argument that the enzyme CYP3A4 helps metabolize levodopa. Inhibiting it slows the metabolism and leads to more levodopa in the body. Unfortunately, CYP3A4 has the same effect on many other drugs; inhibiting CYP3A4 in effect magnifyies their dose, thus possibly leading to dangerous over-dose situations.

Evidence-Based Medicine have written a paper [1] which lists CYP3A4 inhibitors. Those shown below are some of those of moderate strength (defined as between a 2 to a 5-fold increase in AUC and a decrease in clearance of between 50 and 80%).

I thought it would be useful to look at the archives of this forum to see if anyone had reported benefits involving these substances:

- Miconazole, no mention
- Grapefruit juice [4]
- Cat's claw, not specific
- Echinacea, not specific
- Wild cherry [3, for winter cherry]
- Chamomile, not specific
- Licorice [2]

Reference

[1] "Common Medications Classified as Weak, Moderate and Strong Inhibitors of CYP3A4"
Anthony Busti
Evidence-Based Medicine, Consult, 2015
What are some common medications classified as weak, moderate and strong inhibitors of CYP3A4?

[2] Can licorice help those with PD?

[3] Post 10, Waiting on Levodopa

[4] How to double your on time!!

John
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Born 1955. Diagnosed PD 2005.
Meds 2010-Nov 2016: Stalevo(75 mg) x 4, ropinirole xl 16 mg, rasagiline 1 mg
Current meds: Stalevo(75 mg) x 5, ropinirole xl 8 mg, rasagiline 1 mg
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