What does it mean to be a poor metabolizer of CYP2D6?

A deficiency of the CYP2D6 enzyme is inherited as an autosomal recessive trait; these subjects (7% of Caucasians, about 1% of Orientals) are classified as poor metabolizers. Of these, more than 15 encode an inactive or no enzyme at all. Others encode enzyme with reduced, ‘normal’ or increased enzyme activity.

What percentage of drugs are metabolized by CYP2D6?

CYP2D6 metabolizes around 25% of currently prescribed drugs, including various antidepressants, neuroleptics, beta-blockers, opioids, antiemetics, and antiarrhythmics.

What happens if you are a poor metabolizer?

Poor metabolizers – People in this group have little or no active CYP2D6 enzyme. People who are poor metabolizers break down some medicines slowly and are likely to need altered doses or even a different medicine in some cases.

Is metoprolol metabolized by 2d6?

2016 Statement from the US Food and Drug Administration (FDA): Metoprolol is metabolized predominantly by CYP2D6, an enzyme that is absent in about 8% of Caucasians (poor metabolizers) and about 2% of most other populations.

What does it mean to be a poor metabolizer?

Poor Metabolizer. A poor-metabolizing enzyme has very low activity. It is possible to have side effects even with a very low drug dose, because the enzyme is very slow to break down the drug. Rapid or Ultrarapid Metabolizers. These enzymes are very active, often breaking down drugs before they can have any effect.

How do you know if you are a poor metabolizer?

Poor metabolizers have significantly reduced or non-functional enzyme activity. Intermediate metabolizers have low or reduced enzyme activity. Extensive metabolizers have normal enzyme activity. Rapid or ultra-rapid metabolizers have high enzyme activity.

What does it mean to be a poor metabolizer of CYP3A5?

Low risk CYP3A5 metabolizer: low risk means there is no recommended change to a medicine based upon the CYP3A5 gene. Poor metabolizer – This means there are two copies of a decreased function CYP3A5 gene which results in poor CYP3A5 enzyme function.

What does poor metabolizer mean?

Poor Metabolizer (PM) – This means there are two copies of low or no activity genes. This results in very little to no CYP2C19 activity. About 2 out of 100 people have this gene status. Certain drugs should be avoided and patients may need to have their doses of some medications adjusted.

How common is poor metabolizer?

What does a poor metabolizer mean?

Where does metoprolol get metabolized?

Elimination is mainly by biotransformation in the liver, and the plasma half-life ranges from approximately 3 to 7 hours. Less than 5% of an oral dose of metoprolol is recovered unchanged in the urine; the rest is excreted by the kidneys as metabolites that appear to have no beta-blocking activity.

In which organ is metoprolol primarily metabolized?

Elimination: Elimination of Metoprolol Tartrate is mainly by biotransformation in the liver. The mean elimination half-life of Metoprolol is 3 to 4 hours; in poor CYP2D6 metabolizers the half-life may be 7 to 9 hours. Approximately 95% of the dose can be recovered in urine.

Is the enzyme activity of CYP2D6 highly variable?

Among the rest (extensive metabolizers), enzyme activity is highly variable, from extremely high in ultrarapid metabolizers, to markedly reduced in intermediate metabolizers. The CYP2D6gene is highly polymorphic, with more than 70 allelic variants described so far. Of these, more than 15 encode an inactive or no enzyme at all.

What is the frequency of CYP2D6 in Chinese?

The CYP2D6*4allele is almost absent in Chinese and this is the reason for the low incidence (1%) of PM in this population compared with 6% in Caucasians [15]. The frequency of the gene deletion (CYP2D6*5) on the other hand is very similar, i.e. 4–6% in different populations (Table 1).

What kind of drugs can CYP2D6 catalyse?

The CYP2D6 enzyme catalyses the metabolism of a large number of clinically important drugs including antidepressants, neuroleptics, some antiarrhythmics, lipophilic β-adrenoceptor blockers and opioids.

What is the significance of CYP2D6 copy number variation?

CYP2D6 copy number variation may account for the single most impactful genetic anomaly as it relates to pharmacogenetic directed therapies CYP2D6 polymorphisms are significantly associated with therapeutic responses to donepezil in patients with Alzheimer’s disease.