Which of the following is strong CYP1A2 inhibitor? [Select All that apply].

a. Fluvoxamine
b. Ciprofloxacin
c. Caffeine
d. Fluoxetine
e. Cimetidine

Answer: (a,b). Dose adjustments may be necessary in patients with concomitant use of:

Strong CYP1A2 inhibitors (e.g., fluvoxamine, ciprofloxacin, or enoxacin);

Moderate or weak CYP1A2 inhibitors (e.g., oral contraceptives, or caffeine);

CYP2D6 or CYP3A4 inhibitors (e.g., cimetidine, escitalopram, erythromycin, paroxetine, bupropion, fluoxetine, quinidine, duloxetine, terbinafine, or sertraline);

CYP3A4 inducers (e.g., phenytoin, carbamazepine, St. John's wort, and rifampin); or

CYP1A2 inducers (e.g., tobacco smoking).

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