Clinical Pharmacogenetics Implementation Consortium Guideline for CYP2D6, OPRM1, and COMT Genotypes and Select Opioid Therapy.
Document Type
Article
Publication Date
10-2021
Identifier
DOI: 10.1002/cpt.2149
Abstract
Opioids are mainly used to treat both acute and chronic pain. Several opioids are metabolized to some extent by CYP2D6 (codeine, tramadol, hydrocodone, oxycodone, and methadone). Polymorphisms in CYP2D6 have been studied for an association with the clinical effect and safety of these drugs. Other genes that have been studied for their association with opioid clinical effect or adverse events include OPRM1 (mu receptor) and COMT (catechol-O-methyltransferase). This guideline updates and expands the 2014 Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline for CYP2D6 genotype and codeine therapy and includes a summation of the evidence describing the impact of CYP2D6, OPRM1, and COMT on opioid analgesia and adverse events. We provide therapeutic recommendations for the use of CYP2D6 genotype results for prescribing codeine and tramadol and describe the limited and/or weak data for CYP2D6 and hydrocodone, oxycodone, and methadone, and for OPRM1 and COMT for clinical use.
Journal Title
Clinical pharmacology and therapeutics
Volume
110
Issue
4
First Page
888
Last Page
896
MeSH Keywords
Analgesics, Opioid; Catechol O-Methyltransferase; Cytochrome P-450 CYP2D6; Genotype; Humans; Pain; Pharmacogenomic Testing; Pharmacogenomic Variants; Receptors, Opioid, mu
Keywords
Opioid Analgesics; Catechol O-Methyltransferase; Cytochrome P-450 CYP2D6; Genotype; Humans; Pain; Pharmacogenomic Testing; Pharmacogenomic Variants; Receptors, Opioid, mu
Recommended Citation
Crews KR, Monte AA, Huddart R, et al. Clinical Pharmacogenetics Implementation Consortium Guideline for CYP2D6, OPRM1, and COMT Genotypes and Select Opioid Therapy. Clin Pharmacol Ther. 2021;110(4):888-896. doi:10.1002/cpt.2149
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Comments
Grant support