Objective: Previous studies have shown that uvoxamine is metabolized by CYP1A2 and CYP2D6, but there is no information on the impact the various CYP enzymes have on the dierent metabolic pathways of¯uvoxamine biotransformation. The present study was designed to investigate this issue. Methods: The major¯uvoxamine metabolite, the 5-demethoxylated carboxylic acid metabolite, was analyzed in urine from 50 healthy volunteers after intake of a single oral dose of 50 mg¯uvoxamine, and the formation clearance for the metabolite (CL m ) was calculated. Of the subjects, 28 were non-smoking CYP2D6 and CYP2C19 extensive metabolizers (EMs), 12 were smokers and were thus considered to have an induced CYP1A2 activity, 5 were CYP2D6 poor metabolizers (PMs), and 5 were CYP2C19 PMs. In 11 of the nonsmoking EMs, 200 mg caeine was given at another occasion in order to calculate oral caeine clearance as a measure of CYP1A2 activity. In addition, CL m was calculated in ten other subjects given increasing doses of uvoxamine for 4 weeks. Results: Oral clearance of¯uvoxamine was signi®cantly higher in smokers, and signi®cantly lower in CYP2D6 PMs than in non-smoking EMs. CL m was 78% lower in CYP2D6 PMs than in the EMs. Smoking and being a CYP2C19 PM did not in¯uence CL m . There was no signi®cant correlation between oral caeine clearance and CL m . CL m decreased with increasing¯uvoxamine dosage, but the decrease in oral clearance was even higher.
Conclusion:These results indicate that CYP2D6 catalyzes the major metabolic pathway of¯uvoxamine, whereas CYP1A2 seems to catalyze other less important pathways. Both the CYP2D6 and the CYP1A2 pathways seem to be saturated in parallel with increasinḡ uvoxamine dosage.