Impact of Infectious and Inflammatory Disease on Cytochrome P450–Mediated Drug Metabolism and Pharmacokinetics

Infection and inflammation are associated with downregulation of hepatic and extrahepatic cytochrome P450s as well as other drug-metabolizing enzymes and transporters. We review the genesis of inflammatory reactions and discuss the relevance of the inflammation-related regulation of cytochrome P450 enzymes to clinical drug–disease and drug–drug interactions. An understanding of the enzyme specificity and mechanisms of regulation will allow us to make better decisions about adjusting drug dosage regimens when a patient's inflammatory status changes. Clinical Pharmacology & Therapeutics (2009); 85, 4, 434–438 doi:10.1038/clpt.2008.302