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Download CYP2D6 Master Drug List
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CYP2D6 Master Drug List Pain Management Codeine** Oxycodone** Hydrocodone** Tramadol** Various brands Oxycontin, various Various brands Ultram, various Cardiology Carvedilol Metoprolol Propanolol Timolol Propafenone Flecainide Coreg Toprol-XL Inderal, various Blocadren Rythmol Tambocor Other Loratadine Donepezil Dextromethorphan Tamoxifen** Claritin Aricept Various brands Various brands Psychiatry Antidepressants Fluoxetine Fluvoxamine Paroxetine Venlafaxine Duloxetine Maprotiline Mirtazapine Amitriptyline Clomipramine Desipramine Doxepin Imipramine Nortriptyline Trimipramine Prozac Luvox Paxil Effexor Cymbalta Ludiomil Remeron Various brands Ananfranil Norpramin Sinequan Tofranil Pamelor, Aventyl Surmontil Antipsychotics Haloperidol Risperidone Aripiprazole Zuclopenthixol Perphenazine Thioridazine Iloperidine Chlorpromazine Atomoxetine Amphetamine Haldol Risperidol Abilify Various brands Trilafon Mellaril Fanapt Thorazine Strattera Adderall **indicates prodrug LAB NOTES CYP2D6 is a liver enzyme responsible for metabolizing roughly 25% of all drugs, including opioids, many antidepressants, antipsychotics, beta-blockers, and tamoxifen. Detecting variants of the CYP2D6 gene that cause altered CYP2D6 enzymatic activity can identify patients who may be at increased risk of having adverse drug reactions or therapeutic failure to standard dosages of medications metabolized by CYP2D6. Roughly 10% of the population are 2D6 Poor Metabolizers (PMs), meaning they have no 2D6 enzymatic activity. Another 35% of the population are considered Intermediate Metabolizers (IMs) with decreased activity. Still another 1-3% of people are Ultra-Rapid Metabolizers. Both IMs and PMs exhibit decreased metabolic activity, which puts them at risk for side effects to drugs normally inactivated by 2D6 (e.g., venlafaxine, metoprolol), or lack of efficacy for drugs requiring activation by 2D6 (e.g., prodrugs such as opioids, tamoxifen). UMs are the other extreme, having higher than normal enzymatic activity. UMs are at increased risk of failure to active drugs because they clear the drugs too rapidly to benefit from a standard dose. UMs are also at risk of toxic side effects from prodrugs because they convert the drug into an active form more so than expected. Copyright 2012 by PGXL Laboratories
