Abstract Cytochrome P450 3A4 (CYP3A4) is a crucial enzyme involved in the Phase I metabolism of numerous medications used in clinical practice. Its potential significance in pediatric pharmacotherapy is underscored by the unique metabolic profile of children, which differs markedly from adults, especially in neonates, infants, and young children due to developmental changes in enzyme activity. This review explores the critical role of CYP3A4 in the metabolism of drugs used in the pediatric population, with a particular focus on combination drug therapies. Given the high potential for drug-drug interactions in combination therapies, understanding the modulation of CYP3A4 activity is essential for optimizing therapeutic outcomes and minimizing adverse effects. This paper further examines the structural similarities between these medications and bergamottin, a known CYP3A4 inhibitor found in citric fruits such as grapefruit. Variability in CYP3A4 activity, influenced by genetic polymorphisms, developmental stage, and external factors, necessitates careful consideration in the prescribing and management of drugs in children. This review corroborates the need for personalized medicine approaches and enhanced pharmacovigilance to ensure the safe and effective use of CYP3A4-metabolized drugs in the pediatric population. Graphical Abstract

Marin Vander Schaaf

Kyrle Luth

Danyelle M. Townsend

Katherine H. Chessman

Catherine M. Mills

Sandra S. Garner

Yuri K. Peterson

Medicinal Chemistry Research

药物化学研究 (MCRE) 发表关于广泛主题的论文，有利于具有重要、新和最新信息的研究。尽管该期刊的同行评审过程要求很高，但 MCRE 仍然以快速发表而自豪，部分原因在于提交的长度。该杂志发表了关于各种主题的重要研究，其中许多强调分子生物学的结构-活性关系。

Medicinal Chemistry Research publishes research papers on a wide range of topics in the field of medicinal chemistry, aiming to provide important, novel, and up-to-date information. Although the peer-review process of the journal is rigorous, Medicinal Chemistry Research takes pride in its rapid publication, partly due to the relatively short length of submitted manuscripts. The journal covers significant research on various topics, many of which emphasize the structure-activity relationships in molecular biology.

《Medicinal Chemistry Research》发表关于药物化学领域的广泛主题的研究论文，旨在提供重要、新颖和最新的信息。尽管该期刊的同行评审过程要求严格，但《Medicinal Chemistry Research》仍以快速发表而自豪，这部分得益于提交论文的篇幅相对较短。期刊涵盖了多种主题的重要研究，许多研究强调了分子生物学中的结构-活性关系。

Category	Quartile
医学	4
医学, 药物化学	4

CYP3A4 drug metabolism considerations in pediatric pharmacotherapy

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Journal Info

Category	Quartile
CHEMISTRY, MEDICINAL	3