Analysis of Drug Interactions Linked To CYP3A4 or CYP2D6 Substrates to Identify Preventable Interactions

Engineering notes

Key topics: autonomous driving. See the paper for implementation details and experimental results.

Chinese explanation / 中文解读

中文解读待补充：本站会优先为端到端自动驾驶、BEV感知、3D目标检测、轨迹预测、路径规划、LiDAR感知等高价值论文补充中文说明。

Original abstract

Background: Drug–drug interactions (DDIs) mediated by cytochrome P450 (CYP) enzymes remain a major source of preventable medication-related harm. CYP3A4 and CYP2D6 are among the most clinically important isoenzymes involved in the metabolism of commonly prescribed medications and are frequently implicated in clinically significant interactions. However, contemporary evidence regarding the preventability of these interactions has not been comprehensively synthesized. Objective: To map and evaluate published evidence on clinically significant CYP3A4- and CYP2D6-mediated drug interactions and identify interactions that may be preventable through evidence-based medication management strategies. Methods: A scoping review was conducted following the PRISMA-ScR framework. PubMed/MEDLINE was searched for English-language studies published between January 2020 and January 2025. Eligible studies reported clinically relevant CYP3A4- or CYP2D6-mediated drug interactions. Data on interaction mechanisms, severity, therapeutic classes, clinical outcomes, and preventability were extracted and synthesized descriptively. Results: Of 234 records identified, 75 studies met the eligibility criteria and were included in the review. These studies yielded 60 unique clinically significant CYP-mediated drug interactions. CYP3A4 accounted for most interactions (63.3%), while CYP2D6 represented 36.7%. Enzyme inhibition was the predominant mechanism (58.3%), and severe interactions constituted the largest severity category (51.7%). Antineoplastic agents, antimycobacterial drugs, cardiovascular medications, psychotropic agents, antivirals, and immunosuppressants were most frequently involved. Overall, 42 interactions (70.0%) were classified as potentially preventable. Conclusion: A substantial proportion of clinically significant CYP3A4- and CYP2D6-mediated drug interactions are potentially preventable. Optimized medication management, pharmacist-led interventions, therapeutic drug monitoring, and integration of pharmacogenomic information may improve medication safety and support precision pharmacotherapy.

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