Drug General Information (ID: DDIFU2SP9L)
  Drug Name Theophylline Drug Info Disulfiram Drug Info
  Drug Type Small molecule Small molecule
  Therapeutic Class Bronchodilators Alcohol Deterrents
  Structure

 Mechanism of Theophylline-Disulfiram Interaction (Severity Level: Moderate)
     CYP450 enzyme inhibition Click to Show/Hide Mechanism Graph
Could Not Find 2D Structure
      Drug Name Theophylline Disulfiram
      Mechanism CYP450 2E1 substrate CYP450 2E1 inhibitor
      Key Mechanism Factor 1
Factor Name Cytochrome P450 2E1
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Structure Sequence
MSALGVTVALLVWAAFLLLVSMWRQVHSSWNLPPGPFPLPIIGNLFQLELKNIPKSFTRLAQRFGPVFTLYVGSQRMVVMHGYKAVKEALLDYKDEFSGRGDLPAFHAHRDRGIIFNNGPTWKDIRRFSLTTLRNYGMGKQGNESRIQREAHFLLEALRKTQGQPFDPTFLIGCAPCNVIADILFRKHFDYNDEKFLRLMYLFNENFHLLSTPWLQLYNNFPSFLHYLPGSHRKVIKNVAEVKEYVSERVKEHHQSLDPNCPRDLTDCLLVEMEKEKHSAERLYTMDGITVTVADLFFAGTETTSTTLRYGLLILMKYPEIEEKLHEEIDRVIGPSRIPAIKDRQEMPYMDAVVHEIQRFITLVPSNLPHEATRDTIFRGYLIPKGTVVVPTLDSVLYDNQEFPDPEKFKPEHFLNENGKFKYSDYFKPFSTGKRVCAGEGLARMELFLLLCAILQHFNLKPLVDPKDIDLSPIHIGFGCIPPRYKLCVIPRS
Gene Name CYP2E1
Uniprot ID CP2E1_HUMAN
KEGG Pathway hsa:1571
Protein Family Cytochrome P450 family
Protein Function
A cytochrome P450 monooxygenase involved in the metabolism of fatty acids (PubMed:10553002, PubMed:18577768). Mechanistically, uses molecular oxygen inserting one oxygen atom into a substrate, and reducing the second into a water molecule, with two electrons provided by NADPH via cytochrome P450 reductase (NADPH--hemoprotein reductase) (PubMed:10553002, PubMed:18577768). Catalyzes the hydroxylation of carbon-hydrogen bonds. Hydroxylates fatty acids specifically at the omega-1 position displaying the highest catalytic activity for saturated fatty acids (PubMed:10553002, PubMed:18577768). May be involved in the oxidative metabolism of xenobiotics (Probable).
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      Mechanism Description
  • Decreased metabolism of Theophylline caused by Disulfiram mediated inhibition of CYP450 enzyme

Recommended Action
      Management Clinical monitoring of patient response and tolerance and serum theophylline levels is recommended. Patients should be advised to report any signs of theophylline toxicity including nausea, vomiting, diarrhea, headache, restlessness, insomnia, or irregular heartbeat to their physicians.

References
1 Loi CM, Day JD, Jue SG, et al "Dose-dependent inhibition of theophylline metabolism by disulfiram in recovering alcoholics." Clin Pharmacol Ther 45 (1989): 476-86. [PMID: 2721103]
2 Upton RA "Pharmacokinetic interactions between theophylline and other medication (Part II)." Clin Pharmacokinet 20 (1991): 135-50. [PMID: 1709398]