For chronic pain conditions, gabapentinoids (gabapentin & pregabalin) are often first-line treatments because of their effectiveness & safety. They bind to a2d which alters activity of calcium channels on nerves, thereby modulating pain signals before they reach the brain. Pharmacology of gabapentinoids The absorption of gabapentin & pregabalin differ. Gabapentin absorption is slow. Beyond a…
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…
The liver enzyme CYP3A4 is the key body mechanism for metabolizing pain medications. Patients who take pain medications must be aware that drugs, herbs, & genes can complexly alter CYP3A4 activity. Ask your doctor before making changes. Drugs metabolized by CYP3A4 Fentanyl Buprenorphine Oxycodone Methadone Diazepam Midazolam Alprazolam Metoprolol Losartan Amlodipine Rivaroxaban Dabigatran Apixaban Tacrolimus CYP3A4…
