Impact of infectious and inflammatory disease on cytochrome P450-mediated drug metabolism and pharmacokinetics

Clin Pharmacol Ther. 2009 Apr;85(4):434-8. doi: 10.1038/clpt.2008.302. Epub 2009 Feb 11.


Infection and inflammation are associated with down-regulations of hepatic and extrahepatic cytochrome P450s, as well as other drug metabolizing enzymes and transporters. We will review the genesis of inflammatory reactions, and discuss the relevance of the inflammatory regulation of P450 enzymes observations to clinical drug-disease and drug-drug interactions. Mechanistically, understanding the enzyme specificity and mechanisms of regulation will allow us to make better decisions about drug dosage regimens when a patient’s inflammatory status changes.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Animals
  • Communicable Diseases / enzymology*
  • Communicable Diseases / pathology*
  • Cytochrome P-450 Enzyme System / metabolism*
  • Down-Regulation / physiology
  • Drug Interactions / physiology
  • Humans
  • Inflammation / metabolism
  • Inflammation Mediators / physiology*
  • Pharmaceutical Preparations / metabolism*


  • Inflammation Mediators
  • Pharmaceutical Preparations
  • Cytochrome P-450 Enzyme System