National Guideline Clearinghouse | Clinical Pharmacogenetics Implementation Consortium guideline for <em>CYP2D6</em> and <em>CYP2C19</em> genotypes and dosing of tricyclic antidepressants.
July 29, 2013
Guideline Title
Clinical Pharmacogenetics Implementation Consortium guideline for CYP2D6 and CYP2C19 genotypes and dosing of tricyclic antidepressants.
Bibliographic Source(s)
Hicks JK, Swen JJ, Thorn CF, Sangkuhl K, Kharasch ED, Ellingrod VL, Skaar TC, Muller DJ, Gaedigk A, Stingl JC. Clinical Pharmacogenetics Implementation Consortium guideline for CYP2D6 and CYP2C19 genotypes and dosing of tricyclic antidepressants. Clin Pharmacol Ther. 2013 May;93(5):402-8. [40 references] PubMed |
Guideline Status
This is the current release of the guideline.
Clinical Pharmacogenetics Implementation... [Clin Pharmacol Ther. 2013] - PubMed - NCBI
Clinical Pharmacogenetics Implementation... [Clin Pharmacol Ther. 2013] - PubMed - NCBI
Clin Pharmacol Ther. 2013 May;93(5):402-8. doi: 10.1038/clpt.2013.2. Epub 2013 Jan 16.
Clinical Pharmacogenetics Implementation Consortium guideline for CYP2D6 and CYP2C19 genotypes and dosing of tricyclic antidepressants.
Hicks JK, Swen JJ, Thorn CF, Sangkuhl K, Kharasch ED, Ellingrod VL, Skaar TC, Müller DJ, Gaedigk A, Stingl JC; Clinical Pharmacogenetics Implementation Consortium.
Source
Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.Abstract
Polymorphisms in CYP2D6 and CYP2C19 affect the efficacy and safety of tricyclics, with some drugs being affected by CYP2D6 only, and others by both polymorphic enzymes. Amitriptyline, clomipramine, doxepin, imipramine, and trimipramine are demethylated by CYP2C19 to pharmacologically active metabolites. These drugs and their metabolites, along with desipramine and nortriptyline, undergo hydroxylation by CYP2D6 to less active metabolites. Evidence from published literature is presented for CYP2D6 and CYP2C19 genotype-directed dosing of tricyclic antidepressants.
Comment in
- Clinical implementation of pharmacogenetics: more than one gene at a time. [Clin Pharmacol Ther. 2013]
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