CYP2C9 inhibition
CYP2C9 inhibition. Slows the enzyme handling S-warfarin, phenytoin and NSAIDs. S-warfarin is the clinically dominant enantiomer; small shifts move the INR.
What acts on it
- Turmeric / curcumin — inhibits, moderate
- Amiodarone — inhibits, moderate
What is affected by it
- Warfarin (narrow therapeutic index)
- Phenytoin (narrow therapeutic index)
What a clean result means here
A clean result means NO DOCUMENTED INTERACTION IN THIS DATASET. It does not mean safe, and it is not a clearance. Most substances are not in this dataset at all, and for many pairs that are, nobody has ever studied the combination.
In this dataset
- Monoamine oxidase inhibition (prescription MAOIs, RIMAs, linezolid, methylene blue, harmala alkaloids)
- Serotonergic drugs and the serotonin-toxicity mechanism
- Dietary tyramine and L-dopa loads
- The major cytochrome P450 pathways: CYP3A4, CYP2D6, CYP1A2, CYP2C9, CYP2C19 — inhibition and induction
- P-glycoprotein inhibition and induction
- 11β-HSD2 inhibition (the licorice mechanism) and the potassium consequences that follow it
- QT prolongation as an additive pharmacodynamic axis
- Culinary seasonings and common foods with documented pharmacological activity
- A selected set of narrow-therapeutic-index drugs where those shifts matter most
Not in this dataset
- Any substance not named in this dataset — which is most substances. There are tens of thousands of marketed drugs and this table holds fewer than a hundred entries.
- Phase-2 conjugation (UGT, SULT, NAT2, COMT) except where a specific entry names it. The oilahuasca corpus turns heavily on phase 2 and this engine models it only in passing.
- Pharmacogenomics. CYP2D6 and CYP2C19 are strongly polymorphic; a poor metaboliser and an ultra-rapid metaboliser can have opposite outcomes from the same pair, and this engine does not know your genotype.
- Dose, timing, duration, formulation and route — all of which change whether a documented interaction is clinically real for you.
- Renal and hepatic impairment, age, pregnancy, and body composition.
- Additive sedation, respiratory depression, bleeding risk, hypoglycaemia and most other pharmacodynamic axes beyond the ones listed above.
- Herb–herb interactions outside the named entries, and essentially the whole botanical world: most plants have no interaction literature at all.
- Allergy, intolerance, and contamination or adulteration of unregulated products.
- Anything published after the last-reviewed date below.
72 substances, 20 mechanisms, 64 citations. Last reviewed . Primary literature (every DOI resolved against the Crossref API) and FDA drug labelling. There is no free, openly-licensed, comprehensive drug-interaction dataset to draw on; NLM retired its Drug Interaction API on 2024-01-02 and DrugBank's interaction set is a commercial licence.
References
- Volak LP, Ghirmai S, Cashman JR, Court MH (2008). Curcuminoids Inhibit Multiple Human Cytochromes P450, UDP-Glucuronosyltransferase, and Sulfotransferase Enzymes, whereas Piperine is a Relatively Selective CYP3A4 Inhibitor. Drug Metabolism and Disposition. doi:10.1124/dmd.108.020552
- Bahramsoltani R, Rahimi R, Farzaei MH (2017). Pharmacokinetic interactions of curcuminoids with conventional drugs: A review. Journal of Ethnopharmacology. doi:10.1016/j.jep.2017.07.022
- Holbrook AM, Pereira JA, Labiris R, et al. (2005). Systematic Overview of Warfarin and Its Drug and Food Interactions. Archives of Internal Medicine. doi:10.1001/archinte.165.10.1095
- Flockhart DA, Thacker D, McDonald C, Desta Z (2021). The Flockhart Cytochrome P450 Drug-Drug Interaction Table. Division of Clinical Pharmacology, Indiana University School of Medicine. https://drug-interactions.medicine.iu.edu
Every DOI above was resolved against the Crossref API on 2026-09-09 and the returned title checked against the one printed here. Three DOIs in the first draft resolved to real but different papers and were corrected before publication.
Last reviewed . All interaction pages.