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Practice Guideline
. 2019 Jul;106(1):94-102.
doi: 10.1002/cpt.1409. Epub 2019 Apr 13.

Clinical Pharmacogenetics Implementation Consortium Guideline for Cytochrome P450 (CYP)2D6 Genotype and Atomoxetine Therapy

Jacob T Brown  1 , Jeffrey R Bishop  2 , Katrin Sangkuhl  3 , Erika L Nurmi  4 , Daniel J Mueller  5   6 , Jean C Dinh  7 , Andrea Gaedigk  7   8 , Teri E Klein  3 , Kelly E Caudle  9 , James T McCracken  4 , Jose de Leon  10 , J Steven Leeder  7   8
Affiliations
Practice Guideline

Clinical Pharmacogenetics Implementation Consortium Guideline for Cytochrome P450 (CYP)2D6 Genotype and Atomoxetine Therapy

Jacob T Brown et al. Clin Pharmacol Ther. 2019 Jul.

Abstract

Atomoxetine is a nonstimulant medication used to treat attention-deficit/hyperactivity disorder (ADHD). Cytochrome P450 (CYP)2D6 polymorphisms influence the metabolism of atomoxetine thereby affecting drug efficacy and safety. We summarize evidence from the published literature supporting these associations and provide therapeutic recommendations for atomoxetine based on CYP2D6 genotype (updates at www.cpicpgx.org).

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Conflict of interest statement

CONFLICT OF INTEREST

THE AUTHORS DECLARED NO COMPETING INTERESTS FOR THIS WORK.

Figures

Figure 1.
Figure 1.. Atomoxetine Pathway, Pharmacokinetics.
Data observed from Reference (38), M. Whirl-Carrillo, E.M. McDonagh, J. M. Hebert, L. Gong, K. Sangkuhl, C.F. Thorn, R.B. Altman and T.E. Klein. “Pharmacogenomics Knowledge for Personalized Medicine” Clinical Pharmacology & Therapeutics (2012) 92(4): 414–417. Image reproduced and is licensed under CC BY-SA 4.0 from PharmGKB.
See this image and copyright information in PMC

References

    1. PharmGKB. Gene Reference Materials for CYP2D6. <https://www.pharmgkb.org/page/cyp2d6RefMaterials>. Accessed September 16 2016.
    1. CPIC. CPIC Guideline for Atomoxetine based on CYP2D6 genotype. <https://cpicpgx.org/guidelines/cpic-guideline-for-atomoxetine-based-on-c...>.
    1. Crews KR et al. Clinical Pharmacogenetics Implementation Consortium guidelines for cytochrome P450 2D6 genotype and codeine therapy: 2014 update. Clin Pharmacol Ther 95, 376–82 (2014). - PMC - PubMed
    1. Gaedigk A, Simon SD, Pearce RE, Bradford LD, Kennedy MJ & Leeder JS The CYP2D6 activity score: translating genotype information into a qualitative measure of phenotype. Clin Pharmacol Ther 83, 234–42 (2008). - PubMed
    1. Crews KR et al. Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines for codeine therapy in the context of cytochrome P450 2D6 (CYP2D6) genotype. Clin Pharmacol Ther 91, 321–6 (2012). - PMC - PubMed

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