[CamW]

Larry - As a toxicologist, I thought that you might be interested in this website. I'm not sure if you know about Dave Flockhart's website on CYP-450 drug interactions. I found this amazing site about 6 or 7 years ago and have watched it develop into the ultimate resource for cytochrome interactions. Dr. Flockhart is the Director of Clinical Pharmacology at Indiana University. For awhile the site was restricted, but they've opened it up to everyone, again.

The website is very user friendly, and has a lot of "extras" that aren't readily apparent. Dr. Flockhart has broken the interactions into substrates, inhibitors, and inducers listed sequentially under each isoenzyme. If you click on individual drugs you will find the references proving the interaction. He also includes information on the genetics of the cytochrome system, also including references. The search function is different, and kinda cool.

The good doctor has also condensed the main table into another table which lists only Clinically Relevent CYP-450 Interactions which does save time when I use it at work.

If you are feeling particularily affluent, you can order the table in a pocket card format . They use to be free, but now you have to buy at least 10 cards at $3.00/card (there is a volume discount). I know that if I still worked in the system, I'd be taking up a collection so that all the clinicians would have one sticking out of their pocket. The card is update twice a year, but the table is now so complete (as compared with 5 years ago) that you'd only need to order one every other year. Actually, just print off the clinically relevant table and tack it up in the office. I just slid mine into a plastic sleeve and tack it up on the corkboard in my office.

I hope that you are able to use this. - Cam

[T_MD]

Neat. I think I'll email it to my friends still in residency too.

[Larry_Hoover]

Thank's Cam. I often try to interpret drug interactions for others, and that's a really great resource. I didn't realize it was actively updated. I thought it "abandoned". Maybe that corresponds to the time you say it was restricted? Okay, he's back on my list of "consulted references". Thanks.

Sometimes what's not in one reference, I find in another. Such as this one, with four tables that arrange the data in different contexts:

http://www.edhayes.com/startp450.html

Or if I'm trying to explain interactions themselves, and steady state blood concentrations at 5 half-lives, and so on, this has nice explanations (and some drug info, too):

http://www.erowid.org/psychoactives/...enzymes1.shtml

Just for the sheer geekiness of it, but also because these constantly updated tables show activity variability at the different alleles:

http://www.imm.ki.se/CYPalleles/

Another drug table, from an anaesthetist's perspective (lots of other background and links on this page, above and below this table):

http://www.anaesthetist.com/physiol/.../cyp.htm#alpha

And, if I still haven't found what I want, or I'm interested in considering interactions with e.g. herbs, I look here:

http://www.personalhealthzone.com/pg000059.html

Thanks for being such a great resource, dude. Nothing beats someone who works on the front lines, after years of training, for knowing what it's like.

Lar

[CamW]

Thanks Lar! Wonderful links!

I use Dalhousie University's drug interactions page as a starting point. There are some decent links here.

- Cam