合并用药对氯氮平血药浓度的影响文献综述  

Effect of Combined Medication on Blood Concentration of Clozapine:A Literature Review

作　　者：庄红艳[1,2] 刘珊珊 杜海霞[1,2] 房萌[1,2] 朱虹[1,2] 刘杰 果伟[1,2] ZHUANG Hongyan;LIU Shanshan;DU Haixia;FANG Meng;ZHU Hong;LIU Jie;GUO Wei(Beijing Anding Hospital Affiliated to Capital Medical University·National Medical Research Center for Mental Disorders·Beijing Key Laboratory for Diagnosis and Treatment of Mental Disorders,Beijing,China 100088;Capital Medical University·Advanced Innovation Center for Human Brain Protection,Beijing,China 100069)

机构地区：[1]首都医科大学附属北京安定医院·国家精神心理疾病临床医学研究中心·精神疾病诊断与治疗北京市重点实验室,北京100088 [2]首都医科大学·人脑保护高精尖创新中心,北京100069

出　　处：《中国药业》2021年第21期119-123,共5页China Pharmaceuticals

基　　金：北京市属医院科研培育项目[PZ2020031];首都卫生发展科研专项项目[首发2020-1-2031]。

摘　　要：目的探讨合并用药对氯氮平血药浓度的影响。方法采用计算机检索PubMed,BMJ,EBSCO,Elsevier及中国知网、万方、维普等数据库中合并用药导致氯氮平血药浓度变化的临床研究,检索时限为1990年1月至2020年11月,并归纳氯氮平治疗精神疾病时与其他药物联用的相互作用。结果氯氮平主要在肝脏经细胞色素P450同工酶CYP1A2等催化代谢。合用氯硝西泮、苯妥英钠等神经系统药物,氯丙嗪、氟西汀、氟伏沙明、丙戊酸钠、卡马西平等精神系统药物,尼群地平等心血管系统药物,西咪替丁、奥美拉唑等消化系统药物,红霉素、异烟肼、利福平等抗感染药物,均可影响氯氮平的血药浓度。结论服用氯氮平时应定期监测血药浓度,避免联合用药导致氯氮平血药浓度变化,以促进其安全、合理用药。Objective To investigate the effect of combined medication on blood concentration of clozapine.Methods The clinical studies related to the changes in the blood concentration of clozapine caused by combined medication were searched from PubMed,BMJ,EBSCO,Elsevier,CNKI,WanFang,and VIP databases from January 1990 to November 2020.The interaction between clozapine and other drugs was summarized when the two drugs were used in combination to treat psychiatric diseases.Results Clozapine was mainly me tabolized by cytochrome P450 isoenzyme CYP1 A2 in the liver.Combination of nervous system drugs such as clonazepam and phenytoin sodium,psychic system drugs such as chlorpromazine,fluoxetine,fluvoxamine,sodium valproate and carbamazepine,cardiovascular system drugs such as nitrendipine,digestive system drugs such as cimetidine and omeprazole,anti-infective drugs such as erythromycin,isoniazid and rifampin could affect the blood concentration of clozapine.Conclusion When taking clozapine,the blood concentration should be monitored regularly to avoid changes in the blood concentration of clozapine caused by the combined medication,so as to promote safe and rational use of clozapine.

关 键 词：氯氮平 合并用药 血药浓度 合理用药 

分 类 号：R969[医药卫生—药理学] R971.4[医药卫生—药学]