Phenotypes and Emergency Department Visits Among Patients Receiving Opioid Treatment

Is the reduced function of cytochrome P450 2D6 (), via either genotype or inhibitor–mediated phenoconversion, associated with pain-related emergency department (ED) visits among patients taking -metabolized opioids?In this cohort study using a national dataset of 31 669 patients prescribed hydrocodone, tramadol, codeine, or oxycodone, patients who were phenotypic intermediate metabolizers or poor metabolizers, considering genotype and drug interactions, had significantly more pain-related ED visits than patients who were phenotypic ultrarapid metabolizers or phenotypic normal metabolizers.This study suggests that reduced activity impairs the analgesic response of commonly used opioids metabolized via that pathway.

Corresponding Author: Julie A. Johnson, PharmD, Clinical and Translational Science Institute, The Ohio State University, 376 W 10th Ave, Prior Hall, Ste 260, Columbus, OH 43210 (julie.johnson@osumc.edu).

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