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Cytochrome P-450 2D6 Isoenzyme
Aka: Cytochrome P-450 2D6 Isoenzyme, CYP2D6
- Background
- Accounts for 2-5% of hepatic P-450 isoenzymes
- Precautions: CYP2D6 Deficiency
- Populations with CYP2D6 deficiency (poor metabolizers)
- Occurs in 7% of white persons
- Occurs in 2-7% of white persons
- Consequences of CYP2D6 Deficiency
- No response to codeine (not metabolized to active form)
- Exaggerated physiologic response to substrate medications listed below
- References
- Ingelman-Sundberg (2005) Pharmacogenomics J 5:6-13
- Interactions: Metabolized by CYP2D6 (Substrates)
- Neuropsychiatric drugs
- Tricyclics
- Amitriptyline (Elavil)
- Desipramine (Norpramin)
- Imipramine
- Paroxetine (Paxil)
- Nortriptyline (Pamelor)
- Trimipramine (Surmontil)
- Antipsychotics
- Perphenazine (Trilafon)
- Risperidone (Risperdal)
- Haloperidol (Haldol)
- Thioridazine (Mellaril)
- Neurologic
- Donepezil (Aricept)
- Cardiopulmonary Drugs
- Beta Blockers
- Carvedilol (Coreg)
- Metoprolol (Lopressor)
- Propranolol (Inderal)
- Timolol
- Water soluble Beta-Blockers not hepatic metabolized
- May not be affected by CYP2D6 system
- Examples: Sotalol, Nadolol, Atenolol
- 1C Antiarrhythmics
- Encainide
- Flecainide
- Mexiletine
- Propafenone
- Analgesics
- Codeine
- Dextromethorphan
- Oxycodone
- Hydrocodone
- Tramadol (Ultram)
- Interactions: Inhibitor of CYP2D6
- Neuropsychiatric drugs
- Haloperidol (Haldol)
- Thioridazine (Mellaril)
- Fluoxetine (Prozac)
- Paroxetine (Paxil)
- Cardiopulmonary Drugs
- Amiodarone
- Quinidine
- Antibiotics
- Ritonavir
- Terbinafine (Lamisil)
- Miscellaneous
- Celecoxib (Celebrex)
- Cimetidine
- Diphenhydramine (Benadryl)
- Interactions: Inducer of CYP2D6
- Neuropsychiatric drugs
- Fluoxetine (Prozac)
- Paroxetine (Paxil)
- Cardiopulmonary Drugs
- Quinidine
- Amiodarone
- Antibiotics
- Ritonavir
- Miscellaneous
- Cimetidine