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Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for CYP2C9 and HLA‐B Genotypes and Phenytoin Dosing: 2020 Update
Author(s) -
Karnes Jason H.,
Rettie Allan E.,
Somogyi Andrew A.,
Huddart Rachel,
Fohner Alison E.,
Formea Christine M.,
Ta Michael Lee Ming,
Llerena Adrian,
WhirlCarrillo Michelle,
Klein Teri E.,
Phillips Elizabeth J.,
Mintzer Scott,
Gaedigk Andrea,
Caudle Kelly E.,
Callaghan John T.
Publication year - 2021
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1002/cpt.2008
Subject(s) - cyp2c9 , phenytoin , pharmacogenetics , dosing , medicine , therapeutic drug monitoring , pharmacokinetics , therapeutic index , genotype , pharmacology , toxic epidermal necrolysis , guideline , drug , epilepsy , biology , genetics , dermatology , pathology , psychiatry , cytochrome p450 , metabolism , gene
Phenytoin is an antiepileptic drug with a narrow therapeutic index and large interpatient pharmacokinetic variability, partly due to genetic variation in CYP2C9 . Furthermore, the variant allele HLA‐B*15:02 is associated with an increased risk of Stevens–Johnson syndrome and toxic epidermal necrolysis in response to phenytoin treatment. We summarize evidence from the published literature supporting these associations and provide therapeutic recommendations for the use of phenytoin based on CYP2C9 and/or HLA‐B genotypes (updates on cpicpgx.org).