ABSTRACT:
Pregnancy causes major physiological alterations that influence drug metabolism, especially by the cytochrome P450 (CYP450) enzyme system. The changes result in drug pharmacokinetic variability, necessitating careful dosage adjustment to maintain maternal and fetal safety. CYP3A4 and CYP2D6 activity is increased during pregnancy, accelerating drug metabolism, whereas CYP1A2 and CYP2C19 activity is reduced, resulting in changed drug clearance. Genetic polymorphisms also regulate drug responses, affecting therapeutic efficacy and adverse effect risk. The scarcity of clinical pharmacokinetic information in pregnant populations makes it difficult to assess drug safety, requiring complementary approaches like physiologically based pharmacokinetic (PBPK) modeling, liquid biopsy technologies, and AI-driven pharmacogenomic predictions. These technologies allow for personalized dosing strategies, reducing fetal drug exposure while maximizing maternal treatment. Pharmacogenetic screening and therapeutic drug monitoring (TDM) are becoming ever more crucial for personalized medicine during pregnancy pharmacotherapy. Progress is hampered, though, by issues like the absence of a diverse set of pharmacogenomic data, gaps in regulation, and ethical limitations in clinical trials. Future research must combine genetic screening with high-tech drug monitoring methods to advance pregnancy- specific dosing algorithms. Further increases in pharmacogenomic databases, creation of improved in vitro models of the placenta, and overcoming racial genetic heterogeneity will further improve the safety of medications in pregnant women. Interdisciplinary research is key to bridging these knowledge gaps and translating pharmacogenomics to personalized pharmacotherapy in maternal-fetal medicine.
Cite this article:
Sowmya ML, Dhivya C, Satheesh S. Pregnancy-Induced CYP450 Variability: Implications for Personalized Maternal and Fetal Drug Safety. Research Journal of Pharmacology and Pharmacodynamics.2026;18(3):254-4. doi: 10.52711/2321-5836.2026.00034
Cite(Electronic):
Sowmya ML, Dhivya C, Satheesh S. Pregnancy-Induced CYP450 Variability: Implications for Personalized Maternal and Fetal Drug Safety. Research Journal of Pharmacology and Pharmacodynamics.2026;18(3):254-4. doi: 10.52711/2321-5836.2026.00034 Available on: https://www.rjppd.org/AbstractView.aspx?PID=2026-18-3-5
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