Two alkaloids, mitragynine and 7-hydroxymitragynine, has been identified to be the key active substances in Kratom for the plant’s pharmacological effect. How do these two alkaloids affect CYP enzyme activity?
According to the cited reference “Exploration of Cytochrome P450 Inhibition Mediated Drug-Drug Interaction Potential of Kratom Alkaloids”, mitragynine is a selective and potent inhibitor of CYP2D6 via reversible inhibition; it also inhibits CYP2C19 and CYP3A4/5. 7-hydroxymitragynine was found to be a weak inhibitor of CYP2D6 and CYP3A4/5. (Kamble, Shyam H., et al. “Exploration of Cytochrome P450 Inhibition Mediated Drug-Drug Interaction Potential of Kratom Alkaloids.” Toxicology letters (2019).))
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