Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for CYP2D6 Genotype and Dosing of Selective Serotonin Reuptake Inhibitor Fluvoxamine

Selective serotonin reuptake inhibitors (SSRIs) are used for the treatment of major depressive and anxiety disorders, and may be used to treat other psychiatric conditions. Fluvoxamine is metabolized by cytochrome P450 2D6 (CYP2D6) and variations in CYP2D6 may affect drug exposure. CYP2D6 poor metabolizer showed greater drug exposure to fluvoxamine compared to extensive metabolizers at similar drug dose while data are lacking describing the effect of CYP2D6 ultrarapid metabolism on fluvoxamine therapy. Therapeutic guidelines for the SSRI fluvoxamine based on CYP2D6 genotype have been published in Clinical Pharmacology and Therapeutics by the Clinical Pharmacogenetics Implementation Consortium (CPIC) and are available on the PharmGKB website (https://www.pharmgkb.org/guideline/PA166127637).


Type Guideline
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Genomic Competencies

Experts from the disciplines listed below have tagged this resource as fulfulling genomic competencies.

Pharmacist

  • Pharmacogenetics/Pharmacogenomics
    • P1:   To demonstrate an understanding of how genetic variation in a large number of proteins, including drug transporters, drug metabolizing enzymes, direct protein targets of drugs, and other proteins (e.g. signal transduction proteins) influence pharmacokinetics and pharmacodynamics related to pharmacologic effect and drug response
    • P2:   To understand the influence (or lack thereof) of ethnicity in genetic polymorphisms and associations of polymorphisms with drug response
    • P3:   Recognize the availability of evidence based guidelines that synthesize information relevant to genomic/pharmacogenomic tests and selection of drug therapy (e.g. Clinical Pharmacogenomics Implementation Consortium)