Details of Drug Interaction

Details of Drug-Drug Interaction

 Drug General Information (ID: DDIY3W5MIT)
  Drug Name Nevirapine Drug Info Bupropion Drug Info
  Drug Type Small molecule Small molecule
  Therapeutic Class Anti-Hiv Agents Antidepressants
  Structure

 Mechanism of Nevirapine-Bupropion Interaction (Severity Level: Moderate)
     CYP450 enzyme induction Click to Show/Hide Mechanism Graph
Could Not Find 2D Structure
      Drug Name Nevirapine Bupropion
      Mechanism CYP450 2B6 inducer CYP450 2B6 substrate
      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).
    Click to Show/Hide
      Mechanism Description
  • Increased metabolism of Bupropion caused by Nevirapine mediated induction of CYP450 enzyme

Recommended Action
      Management Pharmacologic response to bupropion should be monitored closely whenever a known CYP450 inducer is added to or withdrawn from therapy, and the bupropion dosage adjusted as necessary. When bupropion/naltrexone is used for weight loss, some authorities advise against concomitant use of efavirenz (AU, CA, US). For all other indications, increases in bupropion dosage should be guided by clinical response however, the maximum recommended dosage of bupropion should not be exceeded.

References
1 Cerner Multum, Inc. "Australian Product Information.".
2 Cerner Multum, Inc. "Canadian Product Information.".
3 Cerner Multum, Inc. "UK Summary of Product Characteristics.".
4 James WA, Lippmann S "Bupropion: overview and prescribing guidelines in depression." South Med J 84 (1991): 222-4. [PMID: 1899294]
5 Ketter TA, Jenkins JB, Schroeder DH, Pazzaglia PJ, Marangell LB, George MS, Callahan AM, Hinton ML, Chao J, Post RM "Carbamazepine but not valproate induces bupropion metabolism." J Clin Psychopharmacol 15 (1995): 327-33. [PMID: 8830063]
6 Product Information. Aplenzin (buPROPion). sanofi-aventis , Bridgewater, NJ.
7 Product Information. Contrave (buPROPion-naltrexone). Orexigen Therapeutics Inc, La Jolla, CA.
8 Product Information. Forfivo XL (buPROPion (bupropion)). Almatica Pharma Inc, Parsippany, NJ.
9 Product Information. Sustiva (efavirenz). DuPont Pharmaceuticals, Wilmington, DE.
10 Product Information. Wellbutrin (bupropion). Glaxo Wellcome, Research Triangle Park, NC.
11 Product Information. Wellbutrin SR (bupropion). Glaxo Wellcome, Research Triangle Park, NC.
12 Product Information. Zyban (bupropion). Glaxo Wellcome, Research Triangle Park, NC.