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Garlic should be added to the page due to its affect on CYP3A4 per as well as the mention in the paper and references Jerryfern (talk) 03:50, 20 July 2012 (UTC)

St. John's Wort[edit]

On the table where it list "Ligands, inducers, and inhibitors", St. John's Wort is listed under "inhibitors", while the St. John's Wort page lists it as an inducer. The Irish Intinian (talk) 06:27, 27 October 2011 (UTC)

Do not copy and paste[edit]

The cytochrome P450 proteins are monooxygenases that catalyze many reactions involved in drug metabolism and synthesis of cholesterol, steroids, and other lipids.
No links external or internal on this chunk of techno-speak!
And correct me if I am wrong but a protein that catalyze is usually called an enzyme?

Perhaps break it down:-
Start out simple

Proteins -> refer back to DNA

enzyme -> refer back to protiens

call out technical terms such as metabolism/ize as digest/converts

Then get technical
monooxygenases -> swaps electron-> puts a piss this out tag on it
The mouth chews
The guts mix it up
The liver sorts out the rubbish

The kidneys make piss; given red wine, fillet steak, semen and diazepam...This is what happens
The anus should keep up with the mouth
Or else the semen will reduce
Left as it is this article only informs those who already know (talk) 22:36, 3 May 2012 (UTC)

Milk Thistle[edit]

The source for milk thistle, "A Warning about Milk Thistle and Drug Interactions" on the website HVC Advocate (, references a twelve-year old in-vitro study(Venkataramanan R, Ramachandran V, Komoroski BJ, et al. Milk thistle, a herbal supplement, decreases the activity of CYP3A4 and uridine diphosphoglucuronosyl transferase in human hepatocyte cultures. Drug Metabolism and Disposition 2000;28(11):1270-1273). In 2006, however, the paper "Assessing the clinical significance of botanical supplementation on human cytochrome P450 3A activity: Comparison of a milk thistle and black cohosh product to rifampin and clarithromycin" in the Journal of Clinical Pharmacology found that 300 mg, three times daily of a product standardized to contain 80% silymarin did not affect CYPA in vivo.

I do not know the latest findings, but the article is nevertheless outdated on this point. — Preceding unsigned comment added by (talk) 09:26, 8 November 2012 (UTC)

Grapefruit death[edit]

This source

<ref name="NYTimes">Bakalar, Nicholas. Experts Reveal the Secret Powers of Grapefruit Juice. ''New York Times.'' Published: March 21, 2006. [ Article]</ref>

does not say grapefruit's interaction with the enzyme has caused several deaths. It says a couple of the drugs it interacts with can, if blood levels are too high (probably during a fairly long time) "lead to a serious and sometimes fatal muscle disorder called rhabdomyolysis." I put a dubious-label on the claim and removed the "source". Really I think the statement should be removed, it's a bold claim with nothing to back it up. --Stighammar (talk) 07:21, 3 April 2014 (UTC)

Removed. Anastrophe (talk) 21:27, 24 February 2015 (UTC)

Valerian[edit] This says valerian is an inducer, not a "moderate inhibitor" as this article says in the table, using a weak source.


The article on paracetamol has this bit in the "pharmacokinetics" section: "Production of NAPQI is due primarily to two isoenzymes of cytochrome P450: CYP2E1 and CYP3A4." So, if this is correct, then paracetamol should be listed here as one of the substrates of CYP3A4.


Prior to September 19, 2015, this article asserted that pregabalin was a "prodrug" of gabapentin. This was inaccurate. While pregabalin has a very similar mechanism of action, as well as similiar therapeutic efficacy and clinical indications to gabapentin, no metabolic conversion of pregabalin to gabapentin has ever been reported or proven. Thus, pregabalin is best described as a structural analog or functional analog of gabapentin.

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