Clopidogrel Bupropion

B6 Artemisinin, bupropion, cyclophosphamide, efavirenz, ifosfamide, ketamine, S-mephobarbital, S-mephenytoin (/V-demethylation to nirvanol), methadone, nevirapine, propofol, selegiline, sertraline, ticlopidine Phenobarbital, cyclophosphamide Ticlopidine, clopidogrel... 

Turpeinen M, Tolonen A, Uusitalo J, et al. Effect of clopidogrel and ticlopidine on cytochrome P450 2B6 activity as measured by bupropion hydroxylation. Cbn Pharmacol Ther 2005 77 553-559. 

The display shown on Figure 2 has an alphabetical list of four precipitants (clopidogrel, erythromycin, ticlopidine, and levofloxacin) that have been evaluated with the substrates bupropion and efavirenz and which have shown more than 20% effect in in vivo inhibition. Each precipitant (inhibitor) in the list has its own folder containing more detailed information ... 

B6 (iS)Mephenytoin Af-demethylation 7-Ethoxy-4-trifluoromethylcoumarin 0-deethylation" Bupropion hydroxylation Phenobarbital 2- Isopropenyl-2-methyladamantane 3- Isopropenyl-3-methyldiadamantane Triethylenethiophosphoramide" Ticlopidine Clopidogrel 5-Mephenytoin "... 

Clopidogrel and ticlopidine appear to inhibit the metabolism of bupropion. Dosage adjustments may be necessary. 

A study in healthy subjects given clopidogrel 75 mg once daily for 4 days found that the AUC of a single 150-mg dose of bupropion was increased by 60% and the AUC of its active metabolite, hydroxybupropion was reduced by 52%. ... 

The manufaeturers advise eaution if bupropion is used with drugs such as clopidogrel, cyclophosphamide, ifosfamide, orphenadrine, and ticlopi-dine as bupropion is metabolised to its major metabolite hydroxybupropi-on by CYP2B6 and these drugs are also metabolised by this isoenzyme. - However, there is no evidence to suggest that this is a problem in practice. 

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