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CYP2D6: the enzyme behind how you process many medicines

Why does codeine do nothing for some people and floor others? Often it's one liver enzyme: CYP2D6.

What the science says

CYP2D6 is a liver enzyme that metabolises a large share of commonly prescribed drugs: codeine and tramadol, many antidepressants and antipsychotics, tamoxifen and more. People carry different CYP2D6 versions ("star alleles") that make the enzyme work faster, slower, or not at all, which can change how a standard dose behaves. CPIC publishes prescribing guidance keyed to these phenotypes.

What Aimosti would show you

For pharmacogenes we restate the relevant CPIC guidance for your genotype, phenotype and the guideline's own wording, to take to a prescriber. CYP2D6 is the hard case: its star alleles often involve structural and copy-number changes that a standard variant file can't resolve, so accurate CYP2D6 typing needs specialised analysis of your aligned reads. We'd rather name that limit than guess a result, and it's on our roadmap as a premium read.

What we won't claim

We won't tell you to take or avoid any drug, and we won't infer a CYP2D6 result from a file that can't support it: pharmacogenomics is a conversation to have with your prescriber, not an instruction from us.

Covered in: Pharmacogenomics (CPIC). Restated from: MedlinePlus Genetics: CYP2D6 gene · CPIC: guidelines.