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Case Reports
. 2004 Dec 30;351(27):2827-31.
doi: 10.1056/NEJMoa041888.

Codeine intoxication associated with ultrarapid CYP2D6 metabolism

Yvan Gasche  1 , Youssef Daali, Marc Fathi, Alberto Chiappe, Silvia Cottini, Pierre Dayer, Jules Desmeules
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Free article
Case Reports

Codeine intoxication associated with ultrarapid CYP2D6 metabolism

Yvan Gasche et al. N Engl J Med. .
Free article

Erratum in

  • N Engl J Med. 2005 Feb 10;352(6):638

Abstract

Life-threatening opioid intoxication developed in a patient after he was given small doses of codeine for the treatment of a cough associated with bilateral pneumonia. Codeine is bioactivated by CYP2D6 into morphine, which then undergoes further glucuronidation. CYP2D6 genotyping showed that the patient had three or more functional alleles, a finding consistent with ultrarapid metabolism of codeine. We attribute the toxicity to this genotype, in combination with inhibition of CYP3A4 activity by other medications and a transient reduction in renal function.

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Comment in

  • Genes and the response to drugs.
    Caraco Y. Caraco Y. N Engl J Med. 2004 Dec 30;351(27):2867-9. doi: 10.1056/NEJMe048278. N Engl J Med. 2004. PMID: 15625340 No abstract available.

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