Potential Polymorphic CYP1A2 and CYP2D6-mediated Pharmacokinetic Interactions between Risperidone or Olanzapine and Selected Drugs Intended to Treat COVID-19

Ariana Rojas-Macetas, Geraldine Medalla-Garro, María Saravia, Ricardo Losno, Milton Valderrama-Wong, Ricardo Pariona, Angel Tito Alvarado Yarasca

Research output: Contribution to journalShort surveypeer-review

2 Scopus citations

Abstract

Risperidone/olanzapine are antipsychotics used in Peru to control symptoms of psychosis. The objective was to review the available evidence on potential pharmacokinetic interactions mediated by CYP1A2 and CYP2D6 polymorphic genes between risperidone or olanzapine and selected drugs for the treatment of COVID-19. A bibliographic search was conducted in SciELO and PubMed/Medline. The selection criteria included all types of articles in English and Spanish languages. In this review, the CYP1A2/CYP2D6/CYP3A4 genes that encode their respective enzymes have been described. The olanzapine/risperidone association increases the risk of prolonging the QT interval; chloroquine/hydroxychloroquine decreases metabolism and increases plasma concentration of risperidone; ritonavir decreases metabolism and increases plasma levels of hydroxychloroquine and lopinavir with the risk of prolonging the QT interval of the cardiac cycle and with a tendency to progression towards Torsades de Pointes. Ritonavir increases metabolism and decreases plasma levels of olanzapine. A low incidence of adverse effect was found between risperidone/azithromycin and olanzapine with azithromycin and hydroxychloroquine. Regarding the association of genes: CYP1A2*1D increases and CYP1A2*1F decreases the plasma concentration of olanzapine. Risperidone plasma levels are increased in CYP2D6 intermediate and poor metabolizers compared with normal metabolizers. Other studies indicate no significant association between poor metabolizers of CYP1A2 and CYP2D6 with increased pharmacokinetic parameters. It is concluded that there are potential risks of prolonging the QT interval due to pharmacokinetic interactions mediated by polymorphic genes CYP1A2 and CYP2D6 between risperidone or olanzapine and the drugs selected for the treatment of COVID-19.

Original languageEnglish
Pages (from-to)6-13
Number of pages8
JournalDrug metabolism and bioanalysis letters
Volume16
Issue number1
DOIs
StatePublished - 2023
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2023 Bentham Science Publishers.

Keywords

  • CYP1A2
  • CYP2D6
  • azithromycin
  • depression
  • hydroxyl-chloroquine
  • pharmacokinetic interactions
  • risperidone/olanzapine

Fingerprint

Dive into the research topics of 'Potential Polymorphic CYP1A2 and CYP2D6-mediated Pharmacokinetic Interactions between Risperidone or Olanzapine and Selected Drugs Intended to Treat COVID-19'. Together they form a unique fingerprint.

Cite this