Which of the following is an example of a potent CYP450 inducer that can decrease levels of coadministered drugs?

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Multiple Choice

Which of the following is an example of a potent CYP450 inducer that can decrease levels of coadministered drugs?

Explanation:
Potent inducers of hepatic cytochrome P450 enzymes increase the metabolism of drugs that are substrates of those enzymes, leading to lower plasma levels and potential loss of efficacy. Rifampin strongly induces several CYP450 enzymes (notably CYP3A4) and enhances their expression via the pregnane X receptor, so coadministered drugs get cleared faster. This means their levels drop significantly when given with rifampin, often requiring dose adjustments or alternative therapy. In contrast, fluconazole and ketoconazole inhibit CYP enzymes rather than induce them, raising levels of coadministered drugs, and ciprofloxacin is not a potent inducer.

Potent inducers of hepatic cytochrome P450 enzymes increase the metabolism of drugs that are substrates of those enzymes, leading to lower plasma levels and potential loss of efficacy. Rifampin strongly induces several CYP450 enzymes (notably CYP3A4) and enhances their expression via the pregnane X receptor, so coadministered drugs get cleared faster. This means their levels drop significantly when given with rifampin, often requiring dose adjustments or alternative therapy. In contrast, fluconazole and ketoconazole inhibit CYP enzymes rather than induce them, raising levels of coadministered drugs, and ciprofloxacin is not a potent inducer.

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