Aripiprazole + bupropion/fluoxetine/paroxetine — CYP2D6
- Aripiprazole = CYP2D6/3A4 substrate
- Strong CYP2D6 inhibition ≈ doubles AUC
- fluoxetine/paroxetine
- bupropion also strongly inhibits 2D6
- Reduce oral aripiprazole dose ~50%
- More effect if CYP3A4 also inhibited
Interaction at a glance
- Strong CYP2D6 inhibition ≈ doubles AUC
- fluoxetine/paroxetine
- bupropion also strongly inhibits 2D6
- Reduce oral aripiprazole dose ~50%
Mechanism
- Aripiprazole = CYP2D6/3A4 substrate
Magnitude / time course
- Strong CYP2D6 inhibition ≈ doubles AUC
- fluoxetine/paroxetine
- bupropion also strongly inhibits 2D6
- More effect if CYP3A4 also inhibited
Management
- Reduce oral aripiprazole dose ~50%
Self-check
- About how much should aripiprazole be reduced with a strong CYP2D6 inhibitor?
About 50%.
- Which enzyme drives this aripiprazole interaction?
CYP2D6.
Drugs in this interaction (4)
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