Cytochrome P450 2D6 Inducers

CYP2D6 is a cytochrome P450 monooxygenase that oxidises fatty acids, steroids and retinoids, inserting one atom of molecular oxygen into the substrate and reducing the second to water with two electrons supplied by NADPH through cytochrome P450 reductase. Drugs in this class induce that activity, so a co-administered substrate of the pathway is cleared faster and its exposure falls; FDA defines an inducer by that fall, calling an index inducer strong at a decrease in the AUC of a sensitive substrate of at least 80 percent and moderate at 50 to under 80 percent. CYP2D6 induction is poorly established: the only induction UniProt records for this enzyme is by pregnancy, and FDA's tables of in vitro and clinical index inducers carry no CYP2D6 row at all. A drug belongs here because its recorded effect on CYP2D6 is induction, not inhibition; as MED-RT populates the class, its one member is oritavancin.