Enhanced CYP2C19-mediated drug-drug interaction risk with escitalopram in geriatric populations

Our PBPK modeling-based simulations predicted that the extent of DDI incurred by S-CIT would be greater in older adults than in young adults and vary significantly by CYP2C19 phenotypes (extensive, intermediate, and poor metabolizers). Based on the prediction results, we propose CYP2C19 phenotype-guided S-CIT dosing strategies for older adults. Implementing the proposed dosing recommendation may reduce the incidence of potentially inappropriate use of medication and adverse events in older adults prescribed S-CIT.