plasmon resonance spectroscopy (lspr). these analyses can be used as a high-sensitivity assay of drug binding, and may become integral in further high-throughput assays utilized in initial drug discovery testing. in addition to lspr, cyp3a4-nanodisc complexes have been found helpful in other applications including solid-state nmr, redox potentiometry, and steady-state enzyme kinetics. ligands following is a table of selected substrates, inducers and inhibitors of cyp3a4. where classes of agents are listed, there may be exceptions within the class. inhibitors of cyp3a4 can be classified by their potency, such as: strong inhibitor being one that causes at least a 5-fold increase in the plasma auc values, or more than 80% decrease in clearance. moderate inhibitor being one that causes at least a 2-fold increase in the plasma auc values, or 50–80% decrease in clearance. weak inhibitor being one that causes at least a 1.25-fold but less than 2-fold increase in the plasma auc values, or 20–50% decrease in clearance. selected inducers, inhibitors and substrates of cyp3a4 substratesinhibitorsinducers some immunosuppressants ciclosporin (cyclosporin) tacrolimus sirolimus many chemotherapeutics docetaxel tamoxifen paclitaxel cyclophosphamide doxorubicin erlotinib etoposide ifosfamide teniposide vinblastine vincristine vindesine imatinib irinotecan sorafenib sunitinib vemurafenib temsirolimus anastrozole gefitinib azole antifungals ketoconazole itraconazole macrolides clarithromycin erythromycin telithromycin (not azithromycin) dapsone (in leprosy) tricyclic antidepressants amitriptyline clomipramine imipramine cyclobenzaprine ssris citalopram norfluoxetine sertraline some other antidepressants mirtazapine (nassa) nefazodone reboxetine venlafaxine (snri) trazodone (sari) vilazodone buspirone (anxiolytic) antipsychotics haloperidol aripiprazole risperidone ziprasidone pimozide quetiapine lurasidone opioids (mainly analgesics) alfentanil buprenorphine (analgesic, addiction maintenance treatment) codeine (analgesic, antitussive, antidiarrheal) fentanyl hydrocodone (partial involvement, not the bioactivation factor) methadone (analgesic, addiction maintenance treatment) levacetylmethadol tramadol (to inactive metabolites, do not confuse with metabolism via cyp2d6) benzodiazepines alprazolam midazolam triazolam diazepam (bioactivation to desmethyldiazepam) clonazepam some hypnotics zopiclone zaleplon zolpidem donepezil (acetylcholinesterase inhibitor) statins atorvastatin lovastatin simvastatin cerivastatin (not pravastatin) (not rosuvastatin) calcium channel blockers diltiazem(sensitive substrate) felodipine(sensitive substrate) nifedipine(sensitive substrate) verapamil(sensitive substrate) amlodipine(sensitive substrate) lercanidipine nitrendipine nisoldipine amiodarone (class iii antiarrhythmic) dronedarone (class iii antiarrhythmic) quinidine (class i antiarrhythmic) pde5 inhibitors sildenafil tadalafil kinins (vasodilators, smooth muscle contractors) sex hormones agonists and antagonists finasteride (antiandrogen) estradiol (estrogen) progesterone ethinylestradiol (hormonal contraceptive) testosterone (androgen) toremifene (serm) bicalutamide h1-receptor antagonists terfenadine astemizole chlorphenamine protease inhibitors indinavir ritonavir saquinavir nelfinavir non-nucleoside reverse-transcriptase inhibitors nevirapine some glucocorticoids budesonide hydrocortisone dexamethasone fluticasone albendazole (antihelminthic) cisapride (5-ht4 receptor agonist) aprepitant (antiemetic) caffeine (stimulant) cocaine (stimulant) cilostazol (phosphodiesterase inhibitor) dextromethorphan (antitussive) domperidone (antidopaminergic) eplerenone (aldosterone antagonist) lidocaine (local anesthetic, antiarrhythmic) ondansetron (5-ht3 antagonist) propranolol (beta blocker) salmeterol (beta agonist) warfarin (anticoagulant) clopidogrel, becoming bioactivated (antiplatelet) 2-oxo-clopidogrel omeprazole (proton pump inhibitor) nateglinide (antidiabetic) methoxetamine montelukast (leukotriene receptor antagonist) vilaprisan (selective progesterone receptor modulator) angiotensin ii receptor blocker losartan (sensitive substrates) strong boceprevir protease inhibitors ritonavir indinavir nelfinavir saquinavir some macrolide antibiotics clarithromycin telithromycin ceritinib mibefradil (used for the treatment of hypertension and chronic angina pectoris) nefazodone (antidepressant) ribociclib tucatinib chloramphenicol (antibiotic) some azole antifungals ketoconazole itraconazole posaconazole voriconazole cobicistat moderate amiodarone aprepitant (antiemetic) ciprofloxacin conivaptan crizotinib rutin (in vitro) (dietary flavonoid) tofisopam some calcium channel blockers verapamil diltiazem some macrolide antibiotics erythromycin some azole antifungals fluconazole miconazole bergamottin (constituent of grapefruit juice) cyclosporine donedarone fluvoxamine imatinib valerian weak buprenorphine (analgesic) cafestol (in unfiltered coffee) cilostazol cimetidine fosaprepitant lomitapide orphenadrine omeprazole (proton pump inhibitor) quercetin ranitidine ranolazine tacrolimus ticagrelor valproic acid amlodipine unspecified potency berberine (an alkaloid found in plants like berberis) cannabidiol dithiocarbamate (functional group) mifepristone (abortifacient) norfloxacin (antibiotic) some non-nucleoside reverse-transcriptase inhibitors delavirdine gestodene (hormonal contraceptive) star fruit milk thistle niacin (nicotinic acid) and its form – niacinamide (nicotinamide), collectively called as vitamin b3 ginkgo biloba sesamin (a lignan constituent in sesame seeds and oil) piperine isoniazid strong potency antiandrogens enzalutamide apalutamide phenytoin (anticonvulsant) unspecified potency anticonvulsants, mood stabilizers carbamazepine oxcarbazepine topiramate barbiturates phenobarbital butalbital st. john's wort some bactericidals rifampicin rifabutin some non-nucleoside reverse-transcriptase inhibitors efavirenz nevirapine some hypoglycemics pioglitazone troglitazone glucocorticoids (blood glucose increase, immunosuppressive) modafinil (stimulant) capsaicin brigatinib clobazam dabrafenib elagolix eslicarbazepine letermovir lorlatinib oritavancin perampanel telotristat interactive pathway map click on genes, proteins and metabolites below to link to respective articles. [[file: |alt=irinotecan pathway edit]] irinotecan pathway edit the interactive pathway map can be edited at wikipathways: "irinotecanpathway_wp229".