This is a summary of the CPIC dosing guideline for atomoxetine and variation in the gene CYP2D6.
However, they may also show an improved clinical response and be at a decreased risk of discontinuing to assist with atomoxetine dosing, this guideline provides information about plasma drug concentration the patient initially fails to respond to atomoxetine. this guideline also provides specific recommendations for the use of atomoxetine the *10 allele, they should be
Given a dose increase after 3 days of treatment. peak plasma concentration 1-2 hours after administration should be considered. poor metabolizers or normal metabolizers who carry the *10 allele. the peak plasma concentration 2-4 hours after this image is adapted from the pharmgkb atomoxetine pathway. atomoxetine is a selective norepinephrine treatment of attention deficit
Hyperactivity disorder, or adhd. central to this guideline is the metabolism although 4’-hydroxy atomoxetine is an active metabolite, it is only found at very low concentrations therefore, it is not considered to exert a substantial clinical effect. this puts the patient at an increased risk at an increased risk of discontinuing atomoxetine therapy. as a result, these
Patients may experience there are over 100 different cyp2d6 alleles, each star allele can be assigned an activity this table gives the activity values of some allele functionality table, found on the pharmgkb website. however, it has been observed that the *10 as such, this guideline provides specific further clarification of the activity score end of the cpic cyp2d6 genotype
To phenotype standardization project. be aware that some cyp2d6 alleles have an unknown functional status and should be interpreted in addition, an important caveat for all genotyping this can include rare increased-function, which are not routinely screened for in some genotyping tests. reports in the scientific literature have alleles which are present in multiple copies
Is the number of copies of that allele that are present in a genome. the activity score of alleles that are present the activity score for the allele by the number of copies present. further information about cyp2d6 alleles can be found at the pharmvar website at www.pharmvar.org. a link to pharmvar is also given in the description below this video. the cyp2d6 activity
Score is then used to assign a cyp2d6 metabolizer note that genetic tests from different laboratories may not use this scheme activity score calculated before making clinical a prominent example of this is the assignment which have been assigned a normal metabolizer status by cpic. towards some drugs, including atomoxetine, indeed, some reference laboratories classify this
Current controversy is reflected in the score of 1 are noted to be normal or intermediate metabolizers. patients with a cyp2d6 ultrarapid metabolizer concentrations of atomoxetine using standard dosing. these patients should begin atomoxetine therapy at a dose of 0.5mg/kg/day, increasing to 1.2mg/kg/day if there are no side effects or clinical response plasma concentration
1-2 hours after administration should be considered. patients with a cyp2d6 activity score between 1.5 and 2 are less likely to respond to atomoxetine and are therefore at a higher risk of discontinuing atomoxetine therapy. patients with a cyp2d6 activity score of 1 increased plasma concentrations of atomoxetine activity score, although the clinical significance of this is
Questionable. plasma concentrations of atomoxetine compared to patients with a these patients should begin atomoxetine therapy at a dose of 0.5mg/kg/day. plasma concentration 2-4 hours after administration should be considered. a dose reduction should be considered if the patients with a cyp2d6 intermediate metabolizer atomoxetine compared to normal metabolizers but still
May be at an increased risk of discontinuing patients with a cyp2d6 poor metabolizer phenotype this may lead to an increase in side effects in adhd symptoms compared to other metabolizer phenotypes. the dosing recommendations for atomoxetine in children detailed footnotes pertaining to the recommendations these are the cpic dosing recommendations for atomoxetine in adults.
These patients should begin atomoxetine therapy at a dose of 40mg/day. the dosing recommendations for atomoxetine in adults can be found in table 3 of the guideline. this guideline has been annotated on the pharmgkb website. the activity summary includes implications the appropriate dosing recommendation for remember that variation in other genes in including concomitant
Medications, can affect treatment. cpic and pharmgkb assume no responsibility or property arising out of or related to any the guideline itself and supplementary information are freely available in the description below this video.
Transcribed from video
CPIC guideline for Atomoxetine and CYP2D6 By PharmGKB