The Clinical Pharmacogenetics Implementation Consortium (CPIC) recently published its 2014 update to their Guidelines for Cytochrome P450 2D6 Genotype and Codeine Therapy. This builds on their 2012 guidelines and incorporates new information, including the FDA’s recent warnings regarding the use of codeine following tonsillectomies in children. The new guidelines also expand the recommendations section to include new considerations and notes on other opioids metabolized by CYP2D6 such as oxycodone, hydrocodone and tramadol.

The CPIC was formed in 2009 as part of PharmGKB and the Pharmacogenomics Research Network. CPIC Guidelines are published in peer-reviewed journals in order to help clinicians understand how to use pharmacogenetic test results.

Codeine is an opioid analgesic that is also sometimes used for its antitussive properties. Like all opioids, codeine can be associated with adverse side effects, including severe effects such as respiratory depression. Codeine is metabolized by the genetically variable CYP2D6 enzyme. The CPIC recommends using alternative medications in CYP2D6 poor or ultrarapid metabolizers.

To download a copy of the new paper, go to http://bit.ly/1iUbAmw.