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Opioid Pharmacogenomics: More Than Metabolism

Opioid Pharmacogenomics: More Than Metabolism

This video was recorded at 20th International Symposium on Microsomes and Drug Oxidations (MDO), Stuttgart 2014. Several opioids such as codeine are considered pro-drugs as they are metabolized by the highly polymorphic CYP2D6 to more potent opioids with clinical efficacy and toxicological sequelae. Many opioids are also metabolised by CYP3A4/5. In over 600 cancer patients using fentanyl patches, plasma fentanyl concentrations and the metabolic ratio (norfentanyl/fentanyl) were associated with CYP3A4*22 and CYP3A5*3 genotypes but their overall contribution to variability was < 1%. Pharmacogenomic studies on pharmacodynamic variants remain a poorly investigated field; for opioids, the OPRM1 reduced function A118G variant seems not to play a major role in contributing to the variability in... Show More
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