Drug-herb-gene CYP2D6 interactions

Several pain medications require the liver enzyme CYP2D6 to become active. But some herbal supplements & medications can interfere with this enzyme. Patients on these medications should consult with a doctor before starting herbal supplements.

Drugs activated by CYP2D6

  • Hydrocodone
  • Oxycodone
  • Codeine
  • Tramadol

Drugs deactivated by CYP2D6

  • Amitriptyline
  • Nortriptyline
  • Desipramine
  • Duloxetine
  • Venlafaxine

CYP2D6 inhibitors

Drugs:

  • Bupropion
  • Cimetidine
  • Duloxetine
  • Paroxetine
  • Fluoxetine
  • Sertraline
  • Quinidine
  • Terbinafine

Herbs:

  • Resveratrol
  • Goldenseal
  • Black cumin seed
  • Tumeric

Inflammation

Genes:

  • Poor metabolizer genotype

CYP2D6 inducers

Drugs:

  • Butalbital
  • Dexamethasone

Herbs:

  • St. John’s Wort

Genes:

  • High metabolizer genotype

Gentle pain treatments

Dr. Ming Kao View All →

Pain physician & PhD computational biologist @StanfordPain • Advanced pain interventions with CIPS & FIPP • Opinions mine & not medical advice

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