Which enzyme metabolizes Cogentin (benztropine)?

Which enzyme metabolizes Cogentin (benztropine)?

• A. CYP2D6
• B. CYP3A4
• C. CYP2C9
• D. CYP1A2

Answer: (A)

Benztropine is metabolized mainly by the liver through the cytochrome P450 system, with CYP2D6 serving as the primary oxidative pathway. This makes CYP2D6 the best answer because genetic variations in this enzyme and drugs that inhibit or induce it can significantly alter benztropine levels, influencing both efficacy and anticholinergic side effects. Understanding this helps you anticipate drug interactions. For example, inhibitors of CYP2D6 (like fluoxetine or paroxetine) can raise benztropine exposure, increasing toxicity risk, while inducers can lower levels and reduce effect. Other enzymes such as CYP3A4, CYP2C9, or CYP1A2 may contribute to metabolism to a lesser extent, but they are not the main routes for benztropine, which is why they’re not the best choice here.

Benztropine is metabolized mainly by the liver through the cytochrome P450 system, with CYP2D6 serving as the primary oxidative pathway. This makes CYP2D6 the best answer because genetic variations in this enzyme and drugs that inhibit or induce it can significantly alter benztropine levels, influencing both efficacy and anticholinergic side effects.

Understanding this helps you anticipate drug interactions. For example, inhibitors of CYP2D6 (like fluoxetine or paroxetine) can raise benztropine exposure, increasing toxicity risk, while inducers can lower levels and reduce effect. Other enzymes such as CYP3A4, CYP2C9, or CYP1A2 may contribute to metabolism to a lesser extent, but they are not the main routes for benztropine, which is why they’re not the best choice here.