Drug General Information (ID: DDIGQZYCNM)
  Drug Name Halothane Drug Info Alpelisib Drug Info
  Drug Type Small molecule Small molecule
  Therapeutic Class Anesthetics Pi3K Inhibitors
  Structure

 Mechanism of Halothane-Alpelisib Interaction (Severity Level: Moderate)
     CYP450 enzyme induction Click to Show/Hide Mechanism Graph
Could Not Find 2D Structure
      Drug Name Halothane Alpelisib
      Mechanism CYP450 2B6 substrate CYP450 2B6 inducer
      Key Mechanism Factor 1
Factor Name Cytochrome P450 2B6
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Structure Sequence
MELSVLLFLALLTGLLLLLVQRHPNTHDRLPPGPRPLPLLGNLLQMDRRGLLKSFLRFREKYGDVFTVHLGPRPVVMLCGVEAIREALVDKAEAFSGRGKIAMVDPFFRGYGVIFANGNRWKVLRRFSVTTMRDFGMGKRSVEERIQEEAQCLIEELRKSKGALMDPTFLFQSITANIICSIVFGKRFHYQDQEFLKMLNLFYQTFSLISSVFGQLFELFSGFLKYFPGAHRQVYKNLQEINAYIGHSVEKHRETLDPSAPKDLIDTYLLHMEKEKSNAHSEFSHQNLNLNTLSLFFAGTETTSTTLRYGFLLMLKYPHVAERVYREIEQVIGPHRPPELHDRAKMPYTEAVIYEIQRFSDLLPMGVPHIVTQHTSFRGYIIPKDTEVFLILSTALHDPHYFEKPDAFNPDHFLDANGALKKTEAFIPFSLGKRICLGEGIARAELFLFFTTILQNFSMASPVAPEDIDLTPQECGVGKIPPTYQIRFLPR
Gene Name CYP2B6
Uniprot ID CP2B6_HUMAN
KEGG Pathway hsa:1555
Protein Family Cytochrome P450 family
Protein Function
A cytochrome P450 monooxygenase involved in the metabolism of endocannabinoids and steroids (PubMed:21289075, PubMed:12865317). 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). Catalyzes the epoxidation of double bonds of arachidonoylethanolamide (anandamide) to 8,9-, 11,12-, and 14,15-epoxyeicosatrienoic acid ethanolamides (EpETrE-EAs), potentially modulating endocannabinoid system signaling (PubMed:21289075). Hydroxylates steroid hormones, including testosterone at C-16 and estrogens at C-2 (PubMed:21289075, PubMed:12865317). Plays a role in the oxidative metabolism of xenobiotics, including plant lipids and drugs (PubMed:11695850, PubMed:22909231). Acts as a 1,4-cineole 2-exo-monooxygenase (PubMed:11695850).
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      Mechanism Description
  • Increased metabolism of Halothane caused by Alpelisib mediated induction of CYP450 enzyme

Recommended Action
      Management Caution and monitoring are recommended if alpelisib is used concomitantly with drugs that are substrates of CYP450 2B6, particularly sensitive CYP450 2B6 substrates (e.g. bupropion) or those with a narrow therapeutic window. The potential for diminished therapeutic effects should be considered when alpelisib is prescribed in combination with drugs that are CYP450 2B6 substrates.

References
1 Cerner Multum, Inc. "UK Summary of Product Characteristics.".
2 Product Information. Piqray (alpelisib). Novartis Pharmaceuticals, East Hanover, NJ.