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Tamoxifen 与 Zoloft (Sertraline Tablets)

Tamoxifen 与 Zoloft (Sertraline Tablets)互相作用以及同时服用的可能性。

检测结果:

Tamoxifen <> Zoloft (Sertraline Tablets)

现实性: 06.08.2022 评论家: 医学副博士Shkutko P.M., in

在该服务的官方手册中，已注明相关研究结果统计规定的互相作用。该互相作用或对患者健康引起不良后果，或起到良好效果。具体联合用药问题，需遵从医嘱。

用户:

当使用定期或连续延长的期间，舍曲林可以减少有效性的他在治疗乳腺癌。谈谈你的医生如果你有任何疑问或关切的问题。你的医生可以规定替代品，不进行互动。重要的是要告诉你的医生关于所有其他药物的使用，包括维生素和草药。不停止使用任何药物，没有第一个说你的医生。

医界专家:

一般避免：慢性共同给予的有力度或中度CYP450 2D6抑制剂，包括某些抗抑郁药可能降低效率的他. 拟议的机制是抑制苯氧物活化通过CYP450 2D6到endoxifen(4-羟基-N-desmethyltamoxifen)，活跃的代谢物可能是负责很多他的抗雌激素活性。这是一致的研究报告贫穷的临床结果(例如，增加乳腺癌症复发；较短的复发的时期；降低利率的事件无生存)和减少病/严重性的热潮在治疗的患者与他人有遗传多态性的CYP450 2D6导致减少或者不存在的酶的活动。一个类似的关系已经观察到之间的endoxifen曝光和改建在CYP450 2D6代谢的状态，是否由于CYP450 2D6遗传变异或使用CYP450 2D6抑制剂，例如奎尼丁或SSRI类抗抑郁药。在一项研究的12名患者接受他辅助治疗，意味着等离子浓度的endoxifen下降了超过50%之后四周内帕罗西汀10毫克/天潮热的效果是显而易见的，主要是在患者进行的野型的基因型，用于CYP450 2D6(即广泛的代谢者). 在体外，奎尼丁减少转换到endoxifen通过的79%。潜在的临床影响的这种相互作用的报告中回顾分析的近1 300名女性乳腺癌的患者是新规定他之间2003年和2005年进行了监测，用于在至少两年(平均为2.7年)。妇女使用一种中度到有效的CYP450 2D6抑制剂(n=353)期间，他疗法已经两年乳腺癌的再次发生率为13.9%，相比7.5%，对于那些不采取任何CYP450 2D6抑制剂(n=945). 平均持续时间伴随他和CYP450 2D6抑制剂的使用为340日。在一个子集，分析的病人把他带SSRI类抗抑郁、乳腺癌症复发率16%的报告213妇女使用氟西汀，帕罗西汀，或者舍曲林--Ssri被认为是中度到有效的抑制剂的CYP450 2D6. 这个比率是2.2倍，妇女把他没有CYP450 2D6抑制剂。与此相比，乳腺癌症复发率是8.8％用于137妇女使用酞普兰,依他普仑，或沙明，这不是统计上不同于控制。早，小进行研究的一组丹麦研究人员还报告说没有减少他有效协会与游离或酞普兰使用长达五年。重要的是要注意，不是所有的研究发现之间的关联CYP450 2D6活动和他的临床效果。事实上，一对夫妇的研究，即使报告的减少的风险再次发生在患者与他人有一个共同的遗传变异的CYP450 2D6. 调查表明，存在差异可能是由于差异的研究的设计，包括样品大小不同的基因模型，用于评估的表型，及分层的影响。

管理：根据现有数据，接受治疗的患者与他应该避免长期使用的有效CYP450 2D6抑制剂，例如氟西汀，帕罗西汀，奎尼丁只要有可能，最好也适度的抑制剂，如安非他酮、洛西汀，并舍曲林。如果一种抗抑郁药需要治疗期间他、代理人诸如去甲文拉法辛,沙明、米那普仑、levomilnacipran,米氮平、和文拉法可认为，由于他们有轻度至没有影响CYP450 2D6. 或者，香酶抑制剂，如那曲，依西美坦和唑可能是合适的替代物为他，在某些特定患者。或者，香酶抑制剂，如那曲，依西美坦和唑可能是合适的替代物为他，在某些特定患者。

来源

Goetz MP, Rae JM, Suman VJ, et al. "Pharmacogenetics of tamoxifen biotransformation is associated with clinical outcomes of efficacy and hot flashes." J Clin Oncol 23 (2005): 9312-8
Crewe HK, Notley LM, Wunsch RM, Lennard MS, Gillam EM "Metabolism of tamoxifen by recombinant human cytochrome P450 enzymes: formation of the 4-hydroxy, 4'-hydroxy and N-desmethyl metabolites and isomerization of trans-4-hydroxytamoxifen." Drug Metab Dispos 30 (2002): 869-74
Schroth W, Antoniadou L, Fritz P, et al. "Breast cancer treatment outcome with adjuvant tamoxifen relative to patient CYP2D6 and CYP2C19 genotypes." J Clin Oncol 25 (2007): 5187-93
Goetz MP, Kamal A, Ames MM "Tamoxifen Pharmacogenomics: The Role of CYP2D6 as a Predictor of Drug Response." Clin Pharmacol Ther (2007):
Wegman P, Vainikka L, Stal O, et al "Genotype of metabolic enzymes and the benefit of tamoxifen in postmenopausal breast cancer patients." Breast Cancer Res 7 (2005): R284-90
Henry NL, Stearns V, Flockhart DA, Hayes DF, Riba M "Drug interactions and pharmacogenomics in the treatment of breast cancer and depression." Am J Psychiatry 165 (2008): 1251-5
Lash TL, Pedersen L, Cronin-Fenton D, et al "Tamoxifen's protection against breast cancer recurrence is not reduced by concurrent use of the SSRI citalopram." Br J Cancer 99 (2008): 616-21
Ratliff B, Dietze EC, Bean GR, Moore C, Wanko S, Seewaldt VL "Re: Active tamoxifen metabolite plasma concentrations after coadministration of tamoxifen and the selective serotonin reuptake inhibitor paroxetine." J Natl Cancer Inst 96 (2004): 883; author reply 884-5
Jordan VC, Collins MM, Rowsby L, Prestwich G "A monohydroxylated metabolite of tamoxifen with potent antioestrogenic activity." J Endocrinol 75 (1977): 305-16
Lim HS, Ju Lee H, Seok Lee K, Sook Lee E, Jang IJ, Ro J "Clinical implications of CYP2D6 genotypes predictive of tamoxifen pharmacokinetics in metastatic breast cancer." J Clin Oncol 25 (2007): 3837-45
Amchin J, Ereshefsky L, Zarycranski W, Taylor K, Albano D, Klockowski PM "Effect of venlafaxine versus fluoxetine on metabolism of dextromethorphan, a CYP2D6 probe." J Clin Pharmacol 41 (2001): 443-51
Jin Y, Desta Z, Stearns V, et al. "CYP2D6 genotype, antidepressant use, and tamoxifen metabolism during adjuvant breast cancer treatment." J Natl Cancer Inst 97 (2005): 30-9
Wegman P, Elingarami S, Carstensen J, Stal O, Nordenskjold B, Wingren S "Genetic variants of CYP3A5, CYP2D6, SULT1A1, UGT2B15 and tamoxifen response in postmenopausal patients with breast cancer." Breast Cancer Res 9 (2007): R7
Coller JK, Krebsfaenger N, Klein K, et al. "The influence of CYP2B6, CYP2C9 and CYP2D6 genotypes on the formation of the potent antioestrogen Z-4-hydroxy-tamoxifen in human liver." Br J Clin Pharmacol 54 (2002): 157-167
Dezentje VO, Guchelaar HJ, Nortier JW, van de Velde CJ, Gelderblom H "Clinical implications of CYP2D6 genotyping in tamoxifen treatment for breast cancer." Clin Cancer Res 15 (2009): 15-21
Goetz MP, Loprinzi CL "A hot flash on tamoxifen metabolism." J Natl Cancer Inst 95 (2003): 1734-5
Ponzone R, Biglia N, Sismondi P "Re: Active tamoxifen metabolite plasma concentrations after coadministration of tamoxifen and the selective serotonin reuptake inhibitor paroxetine." J Natl Cancer Inst 96 (2004): 883-4; author reply 884-5
McCaffrey P "Genetics and drug interactions affect tamoxifen metabolism." Lancet Oncol 6 (2005): 72
Gaston C, Kolesar J "Clinical Significance of CYP2D6 Polymorphisms and Tamoxifen in Women with Breast Cancer." Clin Adv Hematol Oncol 6 (2008): 825-33
Borges S, Desta Z, Li L, et al. "Quantitative effect of CYP2D6 genotype and inhibitors on tamoxifen metabolism: Implication for optimization of breast cancer treatment." Clin Pharmacol Ther 80 (2006): 61-74
Stearns V, Johnson MD, Rae JM, et al. "Active tamoxifen metabolite plasma concentrations after coadministration of tamoxifen and the selective serotonin reuptake inhibitor paroxetine." J Natl Cancer Inst 95 (2003): 1758-64
Aubert RE, Stanek EJ, Yao J, et al "Increased risk of breast cancer recurrence in women initiating tamoxifen with CYP2D6 inhibitors. Available from: URL: https://www.medcoresearch.com/community/oncology/tamoxifen." ([2009 May 30]):
Jordan VC "Metabolites of tamoxifen in animals and man: identification, pharmacology, and significance." Breast Cancer Res Treat 2 (1982): 123-38
Rochat B "Role of cytochrome p450 activity in the fate of anticancer agents and in drug resistance : focus on tamoxifen, Paclitaxel and imatinib metabolism." Clin Pharmacokinet 44 (2005): 349-66
Dehal SS, Kupfer D "CYP2D6 catalyzes tamoxifen 4-hydroxylation in human liver." Cancer Res 57 (1997): 3402-6
Desta Z, Ward BA, Soukhova NV, Flockhart DA "Comprehensive evaluation of tamoxifen sequential biotransformation by the human cytochrome P450 system in vitro: prominent roles for CYP3A and CYP2D6." J Pharmacol Exp Ther (2004):
Desta Z, Flockhart DA "Germline pharmacogenetics of tamoxifen response: have we learned enough?" J Clin Oncol 25 (2007): 5147-9
Brauch H, Murdter TE, Eichelbaum M, Schwab M "Pharmacogenomics of tamoxifen therapy." Clin Chem 55 (2009): 1770-82
Johnson MD, Zuo H, Lee KH, et al. "Pharmacological characterization of 4-hydroxy-N-desmethyl tamoxifen, a novel active metabolite of tamoxifen." Breast Cancer Res Treat 85 (2004): 151-9
Lehmann D, Nelsen J, Ramanath V, Newman N, Duggan D, Smith A "Lack of attenuation in the antitumor effect of tamoxifen by chronic CYP isoform inhibition." J Clin Pharmacol 44 (2004): 861-5
Young D "Genetics examined in tamoxifen's effectiveness: recurrence warning urged for labeling." Am J Health Syst Pharm 63 (2006): 2286, 2296
Borgna JL, Rochefort H "Hydroxylated metabolites of tamoxifen are formed in vivo and bound to estrogen receptor in target tissues." J Biol Chem 256 (1981): 859-68
Bonanni B, Macis D, Maisonneuve P, et al. "Polymorphism in the CYP2D6 tamoxifen-metabolizing gene influences clinical effect but not hot flashes: data from the Italian Tamoxifen Trial." J Clin Oncol 24 (2006): 3708-9
Crewe HK, Lennard MS, Tucker GT, Woods FR, Haddock RE "The effect of selective serotonin re-uptake inhibitors on cytochrome P4502D6 (CYP2D6) activity in human liver microsomes." Br J Clin Pharmacol 34 (1992): 262-5