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Clin Pharmacol Ther. 2014 Apr;95(4):376-82. doi: 10.1038/clpt.2013.254. Epub 2014 Jan 23.

Clinical Pharmacogenetics Implementation Consortium guidelines for cytochrome P450 2D6 genotype and codeine therapy: 2014 update.

Author information

1
Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
2
1] Division of Clinical Pharmacology and Therapeutic Innovation, Children's Mercy Hospitals and Clinics, Kansas City, Missouri, USA [2] Department of Pediatrics, University of Missouri-Kansas City, Kansas City, Missouri, USA.
3
Department of Genetics, Stanford University, Stanford, California, USA.
4
1] Department of Pharmaceutics, School of Pharmacy, University of Washington, Seattle, Washington, USA [2] Department of Pharmacy, School of Pharmacy, University of Washington, Seattle, Washington, USA.
5
1] Division of Clinical Pharmacology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA [2] Department of Veterans Affairs, RLR VA Medical Center, Indianapolis, Indiana, USA.
6
1] Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA [2] Department of Anesthesia, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
7
1] Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA [2] Division of Patient Services, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
8
Division of Clinical and Translational Research, Department of Anesthesiology, Washington University in St. Louis, St. Louis, Missouri, USA.
9
Division of Clinical Pharmacology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.

Abstract

Codeine is bioactivated to morphine, a strong opioid agonist, by the hepatic cytochrome P450 2D6 (CYP2D6); hence, the efficacy and safety of codeine are governed by CYP2D6 activity. Polymorphisms are a major cause of CYP2D6 variability. We summarize evidence from the literature supporting this association and provide therapeutic recommendations for codeine based on CYP2D6 genotype. This document is an update to the 2012 Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines for CYP2D6 genotype and codeine therapy.

PMID:
24458010
PMCID:
PMC3975212
DOI:
10.1038/clpt.2013.254
[Indexed for MEDLINE]
Free PMC Article
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