Objective: For clinicians it is challenging to oversee complex drug interactions of multi-drug administration. Rheumatoid arthritis (RA) patients are frequently under long-term medication with multiple anti-inflammatory and pain-relieving drugs, which are mainly metabolized by the Cytochrome P450 enzymes (CYPs). Additionally, treatment of co-morbidities, such as inflammatory periodontal disease (PD) may have to involve further drug administration. The aim of this investigation was to analyze drug interactions in the therapy of RA and PD and to provide a resource for health professionals to easily check interactions and avoid potential side effects. Methods: Information on drug administration in the therapy of RA and PD and expression data of human tissues regarding CYPs was gathered and/or analyzed from scientific literature and web resources. A literature compilation was developed and CYP interaction tables were generated. Results: Side effects, such as enzyme overload or enzyme induction and inhibition may occur in the therapy of RA and PD. To overcome these problems, a web-interface was developed to optimize drug cocktails. The compilation provides manually curated information on the metabolism of 1,500 drugs including 100,000 PubMed references, covering a variety of co-morbidities. Moreover, based on the WHO classification system for drugs (ATC-codes), the knowledge base offers drug alternatives, avoiding CYP-related problems. The web-interface is publicly available: http://bioinformatics.charite.de/perio Conclusions: After a detailed drug anamnesis, health professionals should use a web-interface to check drug interactions involving CYP metabolism, which may circumvent adverse side effects and optimize interdisciplinary drug therapy.
Preissner, S. (2012). Drug Interactions Involving the Cytochrome P450 Enzymes: Analysis of Common Combinations of Antibiotics and Pain Relieving Drugs. Journal of Drug Metabolism & Toxicology, 03(05). https://doi.org/10.4172/2157-7609.1000131