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The enzyme CYP2D6

he enzyme CYP2D6 (full name: Cytochrome P450 2D6) is involved in the metabolisation of xenobiotics, such as drugs. Around 20 to 25% of all drugs are metabolised by CYP2D6. Drugs that can be metabolised by the enzyme CYP2D6 include:

  • Beta blockers such as timolol, S-metoprolol, propranolol, carvedilol
  • Antidepressants such as amitriptyline, clomipramine, desipramine, duloxetine, fluoxetine, imipramine, paroxetine
  • Antidepressants such as doxepin, nortriptyline, venlafaxine
  • Antipsychotics such as haloperidol, risperidone, zuclopenthixol, thioridazine, pimozide, aripiprazole
  • Opioids such as codeine, tramadol, oxycodone
  • Antiarrhythmic drugs such as flecainide, lidocaine, propafenone
  • Other drugs such as atomoxetine (for ADHD), tamoxifen (inhibits growth of oestrogen-sensitive tumours)

Amitriptyline and the enzyme CYP2D6

Amitriptyline is processed to a large extent by the enzyme CYP2D6.

Initially, amitriptyline is metabolised (demethylated) by the enzyme CYP2C19 into another active substance (nortriptyline). The enzymes CYP2C9 and CYP3A4 are also involved in this step to a lesser extent. After this activation step this substance is metabolised further (hydroxylated) by the enzyme CYP2D6 into less active components.

The activity of the enzymes concerned can vary considerably depending on your genetic predisposition, which means the efficacy of amitriptyline can also differ from person to person. Information about your genetic predisposition may therefore provide grounds for extra vigilance in relation to a treatment with amitriptyline.

Read more about Amitriptyline »

Aripiprazole and the enzyme CYP2D6

Aripiprazole is processed to a large extent by the enzyme CYP2D6. The activity of this enzyme can vary considerably depending on your genetic predisposition, which means the efficacy of aripiprazole can also differ from person to person.

Information about your genetic predisposition may therefore provide grounds for extra vigilance in relation to a treatment with aripiprazole.

Read more about Aripiprazole »

Atomoxetine and the enzyme CYP2D6

Atomoxetine is processed to a large extent by the enzyme CYP2D6. The activity of this enzyme can vary considerably depending on your genetic predisposition, which means the efficacy of atomoxetine can also differ from person to person.

Information about your genetic predisposition may therefore provide grounds for extra vigilance in relation to a treatment with atomoxetine.

Read more about Atomoxetine »

Brexpiprazole and the enzyme CYP2D6

Brexpiprazole is processed to a large extent by the enzyme CYP2D6. The activity of this enzyme can vary considerably depending on your genetic predisposition, which means the efficacy of brexpiprazole can also differ from person to person.

Information about your genetic predisposition may therefore provide grounds for extra vigilance in relation to a treatment with brexpiprazole.

Read more about Brexpiprazole »

Clomipramine and the enzyme CYP2D6

Clomipramine is processed to a large extent by the enzymes CYP2D6 and CYP2C19.

Initially, clomipramine is metabolised (demethylated) by the enzyme CYP2C19 into another active substance. The enzymes CYP1A2 and CYP3A4 are also involved in this step to a lesser extent. After this activation step this substance is metabolised further (hydroxylated) by the enzyme CYP2D6 into less active components.

The activity of the enzymes concerned can vary considerably depending on your genetic predisposition, which means the efficacy of clomipramine can also differ from person to person. Information about your genetic predisposition may therefore provide grounds for extra vigilance in relation to a treatment with clomipramine.

Read more about Clomipramine »

Codeine and the enzyme CYP2D6

Codeine is processed to a large extent by the enzyme CYP2D6. The activity of this enzyme can vary considerably depending on your genetic predisposition, which means the efficacy of codeine can also differ from person to person.

Information about your genetic predisposition may therefore provide grounds for extra vigilance in relation to a treatment with codeine.

Read more about Codeine »

Doxepin and the enzyme CYP2D6

Doxepin is processed to a large extent by the enzyme CYP2D6.

Initially, doxepin is metabolised (demethylated) by the enzyme CYP2C19 into another active substance. The enzymes CYP1A2, CYP2C9 and CYP3A4 are also involved in this step to a lesser extent. After this activation step this substance is metabolised further (hydroxylated) by the enzyme CYP2D6 into less active components.

The activity of the enzymes concerned can vary considerably depending on your genetic predisposition, which means the efficacy of doxepin can also differ from person to person. Information about your genetic predisposition may therefore provide grounds for extra vigilance in relation to a treatment with doxepin.

Read more about Doxepin »

Eliglustat and the enzyme CYP2D6

Eliglustat is processed to a large extent by the enzyme CYP2D6. The activity of this enzyme can vary considerably depending on your genetic predisposition, which means the efficacy of eliglustat can also differ from person to person.

Information about your genetic predisposition may therefore provide grounds for extra vigilance in relation to a treatment with eliglustat.

Read more about Eliglustat »

Flecainide and the enzyme CYP2D6

Flecainide is processed to a large extent by the enzyme CYP2D6. The activity of this enzyme can vary considerably depending on your genetic predisposition, which means the efficacy of flecainide can also differ from person to person.

Information about your genetic predisposition may therefore provide grounds for extra vigilance in relation to a treatment with flecainide.

Read more about Flecainide »

Haloperidol and the enzyme CYP2D6

Haloperidol is processed to a large extent by the enzyme CYP2D6. The activity of this enzyme can vary considerably depending on your genetic predisposition, which means the efficacy of haloperidol can also differ from person to person.

Information about your genetic predisposition may therefore provide grounds for extra vigilance in relation to a treatment with haloperidol.

Read more about Haloperidol »

Imipramine and the enzyme CYP2D6

Imipramine is processed to a large extent by the enzymes CYP2D6 and CYP2C19.

Initially, imipramine is metabolised (demethylated) by the enzyme CYP2C19 into another active substance. The enzymes CYP1A2 and CYP3A4 are also involved in this step to a lesser extent. After this activation step this substance is metabolised further (hydroxylated) by the enzyme CYP2D6 into less active components.

The activity of the enzymes concerned can vary considerably depending on your genetic predisposition, which means the efficacy of imipramine can also differ from person to person. Information about your genetic predisposition may therefore provide grounds for extra vigilance in relation to a treatment with imipramine.

Read more about Imipramine »

Metoprolol and the enzyme CYP2D6

Metoprolol is processed to a large extent by the enzyme CYP2D6. The activity of this enzyme can vary considerably depending on your genetic predisposition, which means the efficacy of metoprolol can also differ from person to person.

Information about your genetic predisposition may therefore provide grounds for extra vigilance in relation to a treatment with metoprolol.

Read more about Metoprolol »

Nortriptyline and the enzyme CYP2D6

Nortriptyline is processed to a large extent by the enzyme CYP2D6. The activity of this enzyme can vary considerably depending on your genetic predisposition, which means the efficacy of nortriptyline can also differ from person to person. Information about your genetic predisposition may therefore provide grounds for extra vigilance in relation to a treatment with nortriptyline.

*The enzyme CYP2C19 also plays a (limited) role in the processing of nortriptyline. However, no specific guidelines have been formulated on the basis of this enzyme.

Read more about Nortriptyline »

Paroxetine and the enzyme CYP2D6

Paroxetine is processed within the body primarily by the enzyme CYP2D6. The activity of this enzyme can vary considerably depending on your genetic predisposition, which means the efficacy of paroxetine can also differ from person to person.

Information about your genetic predisposition may therefore provide grounds for extra vigilance in relation to a treatment with paroxetine.

Read more about Paroxetine »

Pimozide and the enzyme CYP2D6

Pimozide is processed to a large extent by the enzyme CYP2D6. The activity of this enzyme can vary considerably depending on your genetic predisposition, which means the efficacy of pimozide can also differ from person to person.

Information about your genetic predisposition may therefore provide grounds for extra vigilance in relation to a treatment with pimozide.

Read more about Pimozide »

Propafenone and the enzyme CYP2D6

Propafenone is processed to a large extent by the enzyme CYP2D6. The activity of this enzyme can vary considerably depending on your genetic predisposition, which means the efficacy of propafenone can also differ from person to person.

Information about your genetic predisposition may therefore provide grounds for extra vigilance in relation to a treatment with propafenone.

Read more about Propafenone »

Tamoxifen and the enzyme CYP2D6

Tamoxifen is processed to a large extent by the enzyme CYP2D6. The activity of this enzyme can vary considerably depending on your genetic predisposition, which means the efficacy of tamoxifen and the risk of side effects can differ from person to person.

Information about your genetic predisposition may therefore provide grounds for extra vigilance in relation to a treatment with tamoxifen.

Read more about Tamoxifen »

Tramadol and the enzyme CYP2D6

Tramadol is processed to a large extent by the enzyme CYP2D6. The activity of this enzyme can vary considerably depending on your genetic predisposition, which means the efficacy of tramadol can also differ from person to person.

Information about your genetic predisposition may therefore provide grounds for extra vigilance in relation to a treatment with tramadol.

Read more about Tramadol »

Venlafaxine and the enzyme CYP2D6

Venlafaxine is processed within the body primarily by the enzyme CYP2D6. The activity of this enzyme can vary considerably depending on your genetic predisposition, which means the efficacy of venlafaxine can also differ from person to person.

Information about your genetic predisposition may therefore provide grounds for extra vigilance in relation to a treatment with venlafaxine.

Read more about Venlafaxine »

Zuclopenthixol and the enzyme CYP2D6

Zuclopenthixol is processed to a large extent by the enzyme CYP2D6. The activity of this enzyme can vary considerably depending on your genetic predisposition, which means the efficacy of zuclopenthixol can also differ from person to person.

Information about your genetic predisposition may therefore provide grounds for extra vigilance in relation to a treatment with zuclopenthixol.

Read more about Zuclopentixol »

Genetic predisposition
The activity of the enzyme CYP2D6 varies from one individual to another. As a result, the efficacy of a drug can differ from person to person, as can the potential side effects. This variation can be partly explained by genetic variations in the CYP2D6 gene.
When a genotype is determined these variations in the CYP2D6 gene are indicated by two so-called alleles. Each allele has a name consisting of an asterisk (*) and a number. An example of a possible CYP2D6 genotype is CYP2D6*1/*33.
At iGene we determine the following variants (alleles) of the CYP2D6 gene: CYP2D6*3, CYP2D6*4, CYP2D6*6, CYP2D6*7, CYP2D6*10, CYP2D6*12, CYP2D6*14, CYP2D6*17, CYP2D6*20, CYP2D6*29, CYP2D6*33, CYP2D6*35, CYP2D6*38, CYP2D6*41, CYP2D6*42 and other (classified as CYP2D6*1). Gene duplication is not currently determined.