CYP2D6 phenotypes and opioid metabolism: the path to personalized analgesia.
Expert Opin Drug Metab Toxicol
; 18(4): 261-275, 2022 Apr.
Article
in English
| MEDLINE | ID: covidwho-1956525
ABSTRACT
INTRODUCTION:
Opioids play a fundamental role in chronic pain, especially considering when 1 of 5 Europeans adults, even more in older females, suffer from it. However, half of them do not reach an adequate pain relief. Could pharmacogenomics help to choose the most appropriate analgesic drug? AREAS COVERED The objective of the present narrative review was to assess the influence of cytochrome P450 2D6 (CYP2D6) phenotypes on pain relief, analgesic tolerability, and potential opioid misuse. Until December 2021, a literature search was conducted through the MEDLINE, PubMed database, including papers from the last 10 years. CYP2D6 plays a major role in metabolism that directly impacts on opioid (tramadol, codeine, or oxycodone) concentration with differences between sexes, with a female trend toward poorer pain control. In fact, CYP2D6 gene variants are the most actionable to be translated into clinical practice according to regulatory drug agencies and international guidelines. EXPERT OPINION CYP2D6 genotype can influence opioids' pharmacokinetics, effectiveness, side effects, and average opioid dose. This knowledge needs to be incorporated in pain management. Environmental factors, psychological together with genetic factors, under a sex perspective, must be considered when you are selecting the most personalized pain therapy for your patients.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Cytochrome P-450 CYP2D6
/
Pain Management
/
Analgesia
/
Analgesics, Opioid
Type of study:
Prognostic study
/
Reviews
Topics:
Variants
Limits:
Humans
Language:
English
Journal:
Expert Opin Drug Metab Toxicol
Journal subject:
Metabolism
/
Toxicology
Year:
2022
Document Type:
Article
Affiliation country:
17425255.2022.2085552
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