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Cytochrome P-450 2D6 IsoenzymeAka: CYP2D6

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  1. Background
    1. Accounts for 2-5% of hepatic P-450 isoenzymes
  2. Precautions: CYP2D6 Deficiency
    1. Populations with CYP2D6 deficiency (poor metabolizers)
      1. Occurs in 7% of white persons
      2. Occurs in 2-7% of white persons
    2. Consequences of CYP2D6 Deficiency
      1. No response to codeine (not metabolized to active form)
      2. Exaggerated physiologic response to substrate medications listed below
    3. References
      1. Ingelman-Sundberg (2005) {a 18555} J 5:6
  3. Interactions: Metabolized by CYP2D6 (Substrates)
    1. Neuropsychiatric drugs
      1. Tricyclics
        1. Amitriptyline (Elavil)
        2. Desipramine (Norpramin)
        3. Imipramine
        4. Paroxetine (Paxil)
        5. Nortriptyline (Pamelor)
        6. Trimipramine (Surmontil)
      2. Antipsychotics
        1. Perphenazine (Trilafon)
        2. Risperidone (Risperdal)
        3. Haloperidol (Haldol)
        4. Thioridazine (Mellaril)
      3. Neurologic
        1. Donepezil (Aricept)
    2. Cardiopulmonary Drugs
      1. Beta Blockers
        1. Carvedilol (Coreg)
        2. Metoprolol (Lopressor)
        3. Propranolol (Inderal)
        4. Timolol
        5. Water soluble Beta-Blockers not hepatic metabolized
          1. May not be affected by CYP2D6 system
          2. Examples: Sotalol, Nadolol, Atenolol
      2. 1C Antiarrhythmics
        1. Encainide
        2. Flecainide
        3. Mexiletine
        4. Propafenone
    3. Analgesics
      1. Codeine
      2. Dextromethorphan
      3. Oxycodone
      4. Hydrocodone
      5. Tramadol (Ultram)
  4. Interactions: Inhibitor of CYP2D6
    1. Neuropsychiatric drugs
      1. Haloperidol (Haldol)
      2. Thioridazine (Mellaril)
      3. Fluoxetine (Prozac)
      4. Paroxetine (Paxil)
    2. Cardiopulmonary Drugs
      1. Amiodarone
      2. Quinidine
    3. Antibiotics
      1. Ritonavir
      2. Terbinafine (Lamisil)
    4. Miscellaneous
      1. Celecoxib (Celebrex)
      2. Cimetidine
      3. Diphenhydramine (Benadryl)
  5. Interactions: Inducer of CYP2D6
    1. Neuropsychiatric drugs
      1. Fluoxetine (Prozac)
      2. Paroxetine (Paxil)
    2. Cardiopulmonary Drugs
      1. Quinidine
      2. Amiodarone
    3. Antibiotics
      1. Ritonavir
    4. Miscellaneous
      1. Cimetidine

Cytochrome P-450 CYP2D6 (C0057223)

Definition (MSH)A cytochrome P450 enzyme that catalyzes the hydroxylation of many drugs and environmental chemicals, such as DEBRISOQUINE; ADRENERGIC RECEPTOR ANTAGONISTS; and TRICYCLIC ANTIDEPRESSANTS. This enzyme is deficient in up to 10 percent of the Caucasian population.
Definition (NCI)This protein is a member of the cytochrome P450 superfamily of enzymes. The cytochrome P450 proteins are monooxygenases which catalyze many reactions involved in drug metabolism and synthesis of cholesterol, steroids and other lipids. This protein localizes to the endoplasmic reticulum and is known to metabolize as many as 20% of commonly prescribed drugs. Its substrates include debrisoquine, an adrenergic-blocking drug; sparteine and propafenone, both anti-arrhythmic drugs; and amitriptyline, an anti-depressant. The gene is highly polymorphic in the population; certain alleles result in the poor metabolizer phenotype, characterized by a decreased ability to metabolize the enzyme's substrates. (from LocusLink)
ConceptsAmino Acid, Peptide, or Protein (T116) , Enzyme (T126)
MSHD019389
EnglishCYP 002 D 006, CYP 2D6, CYP2D6, CYPIID6, CYTOCHROME P 450 CYP 002 D 006, Cytochrome P 450 CYP2D6, Cytochrome P-450 CYP2D6, Cytochrome P450 2D6, Cytochrome p450 CYP2D6 enzyme, Cytochrome P450 Subfamily IID Polypeptide 6, Debrisoquine 4 Hydroxylase, Debrisoquine 4 Monooxygenase, Debrisoquine 4-Hydroxylase, Debrisoquine 4-Monooxygenase, Debrisoquine Hydroxylase, DEBRISOQUINE HYDROXYLASE 04, EC 1.14.14.1, Flavoprotein-Linked Monooxygenase, Imipramine 2 Hydroxylase, Imipramine 2-Hydroxylase, Microsomal Monooxygenase, P450-2D6, P450-DB1, P450DB1, Sparteine Monooxygenase, Xenobiotic Monooxygenase
Spanishenzima CYP2D6 de citocromo p450
Parent ConceptsAryl Hydrocarbon Hydroxylases (C0003927), Cytochrome P450 (C0010762)
SourcesMSH, MTH, NCI, NDFRT, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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