Key takeaways:
- The CYP2B6 enzyme is part of the body’s first line of defense in detoxifying and breaking down certain substances.
- CYP2B6 is important for metabolizing several medications, and genetic variants can affect how the medications work.
- Genetic variants in the CYP2B6 gene can affect your response to specific medications, and understanding your genes may help your doctor with dosing or medication choices.
This article is part of the Detoxification and Medication Genetic Lifehacks Hub.
Members will see their genotype report below and the solutions in the Lifehacks section. Consider joining today.CYP2B6, genetic SNPs, and medication interactions:
The CYP2B6 gene is part of the CYP450 (cytochrome P45) family of phase I genes. It encodes an enzyme that helps break down (metabolize) certain substances, making them more easily eliminated from the body.
CYP2B6 breaks down medications, toxins, and certain hormones made in the body (endogenous substances).
Genetic variants in the CYP2B6 gene cause large variations in how the enzyme works, depending on the variant. For some people, genetic variants cause significant decreases in enzyme function, while others may have faster enzyme function.[ref]
CYP2B6 Drug Substrates:
Drugs metabolized by CYP2B6 include:[ref][ref][ref]
- methadone
- propofol
- bupropion (Wellbutrin brand name)
- ketamine
- cyclophosphamide
- mephobarbital
- coumarins
- diazepam
- efavirenz – HIV medication
- nicotine (along with CYP2A6)[ref]
- sertraline – (along with other CYP enzymes)[ref]
Sex differences:
In general, the CYP2B6 enzyme function is a little higher in women than in men.[ref]
Backup routes:
Many drugs can be metabolized using multiple CYP enzymes.
For example, diazepam primarily uses CYP2B6 for metabolism, but it can also be broken down by CYP2C19 or CYP3A4. So even if you have a genetic variant that impairs CYP2B6, you may still be able to take some of the medications that both CYP2B6 and other CYP450 enzymes metabolize.
Natural supplements metabolized by CYP2B6:
Just like prescription and OTC medications, natural supplements can also interact with the CYP enzymes.
Supplements metabolized by CYP2B6:
- Dihydromethysticin (in Kava)[ref]
- Gambogic acid
- Epsilon-viniferin (from resveratrol), when consumed with alcohol, may inhibit CYP2B6 [ref]
Related article: Resveratrol: Genetic Interactions and Bioavailability
Natural inhibitors of CYP2B6 (watch for interactions with CYP2B6 medications):
- Curcumin (turmeric)[ref]
- Artemisinin, artemisia [ref]
- Astragalus [ref]
- Luteolin (only at high levels)[ref]
Related article: Luteolin & Curcumin research studies
Endogenous substances broken down by CYP2B6:
While we often focus on drug interactions, the CYP enzymes all break down substances that are naturally made in the body – endogenous compounds.
Similarly to drugs, many of the endogenous substances broken down by the CYP enzymes can also be metabolized by multiple routes, multiple enzymes. Thus, an impaired CYP2B6 enzyme may not be a huge problem unless combined with other CYP variants.
- Estrogens – estrone and 17beta-estradiol (along with other CYP enzymes)[ref]
- Testosterone (minor route of metabolism through CYP2B6)[ref]
Phthalates are endocrine disruptors that can mimic estrogen. Some phthalates are also metabolized by CYP2B6.[ref]
What does CYP2B6 do besides break down medications and hormones?
An animal study in mice shows that reduced CYP2B6 function causes problems with metabolizing corn oil.
Mice with reduced CYP2B6 function ended up becoming more obese and having higher triglycerides and cholesterol (compared to normal mice) when fed a bunch of corn oil.[ref]
Pesticides and pollutants metabolism:
CYP2B6 plays a role in breaking down several important classes of environmental toxins.
- The CYP2B6 enzyme also metabolizes organophosphates at lower concentrations, such as from normal exposure to pesticide residue.[ref]
- CYP2B6 is the only enzyme in the body that can break down methoxychlor, which is an insecticide used against flies. It is a banned substance in the EU and the US.[ref]
- PCBs (polychorinated biphenyls) are also metabolized by CYP2B6, along with other CYP450 enzymes.[ref]
CYP2B6 Genotype Report:
Below you will see your genotypes for several of the well-researched SNPs in CYP2B6. You can check out specific drug interactions on ClinPGX for these SNPs. You can use this information to then know whether to talk with your doctor about any of the medications and whether further pharmacogenomic testing is needed.
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Lifehacks:
If you are taking a medication that is metabolized using CYP2B6, talk with your doctor or pharmacist if you have questions about the dosage.
Interactions with slow CYP2B6:
If you are a slower CYP2B6 metabolizer, interactions with other medications may become more important. For example, clopidogrel also inhibits the CYP2B6 enzyme.[ref]
Curcumin, a popular anti-inflammatory supplement, is an inhibitor of CYPB6.[ref] If you have variants that slow down CYP2B6, taking a curcumin supplement along with a medication metabolized by CYP2B6 may impact the way the medication works.
Related article: Curcumin Supplements: Decreasing Inflammation
Astragalus is another natural supplement that inhibits CYP2B6.[ref]
Again, it is likely that a combination of genetic variants that slow the enzyme function, plus a natural inhibitor of CYP2B6, could cause problems with medications. This is something to talk with your doctor or pharmacist about if you have questions.
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Related Articles and Topics:
Nrf2 Pathway: Increasing the Body’s Ability to Get Rid of Toxins
References:
Lyu, Zhaoqing, et al. “Relationships among CYP2B6 Genetic Variants and Serum Levels of Multiple Polychlorinated Biphenyls and Hydroxylated Metabolites in a Japanese Population.” Journal of Hazardous Materials, vol. 486, Mar. 2025, p. 136953. DOI.org (Crossref), https://doi.org/10.1016/j.jhazmat.2024.136953.