Document Detail

Genetic transmission of cytochrome P450 2D6 (CYP2D6) ultrarapid metabolism: implications for breastfeeding women taking codeine.
MedLine Citation:
PMID:  21241245     Owner:  NLM     Status:  MEDLINE    
The pro-drug codeine is commonly prescribed for postpartum pain relief in North America. The safety of codeine during breastfeeding is related in part to the extent of the active morphine metabolite catalyzed from codeine via the cytochrome P450 2D6 (CYP2D6) enzyme. In mothers who have greater than two functional copies of the CYP2D6 gene (CYP2D6 ultrarapid metabolism phenotype; UM) a substantially higher proportion of morphine is produced. Label changes on codeine-containing medications will highlight the risks associated with this genotype for breastfeeding mothers, but are not supported by translation strategies on how to incorporate this pharmacogenetic knowledge into clinical practice. To address the immediate issue of CYP2D6 UM inheritance in family members of a breastfed infant who succumbed to fatal opioid intoxication and whose codeine-prescribed mother was a CYP2D6 UM, we constructed a pedigree. While the pedigree approach is helpful to aid diagnosis, identify other at risk family members, and simplify pharmacogenetic analysis, its clinical usefulness is dependant on an institutional framework which is not available in most centers at this time.
Parvaz Madadi; Catherine Ciszkowski; Andrea Gaedigk; J Steven Leeder; Ronni Teitelbaum; David Chitayat; Gideon Koren
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Current drug safety     Volume:  6     ISSN:  2212-3911     ISO Abbreviation:  Curr Drug Saf     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-01-31     Completed Date:  2011-12-12     Revised Date:  2012-07-19    
Medline Journal Info:
Nlm Unique ID:  101270895     Medline TA:  Curr Drug Saf     Country:  United Arab Emirates    
Other Details:
Languages:  eng     Pagination:  36-9     Citation Subset:  IM    
Division of Clinical Pharmacology and Toxicology, and the Motherisk Program, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada.
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MeSH Terms
Breast Feeding*
Codeine / administration & dosage,  adverse effects*,  biosynthesis
Cytochrome P-450 CYP2D6 / genetics*,  metabolism*
Milk, Human / enzymology*
Reg. No./Substance:
76-57-3/Codeine; EC P-450 CYP2D6

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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