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Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for CYP2C19 and Proton Pump Inhibitor Dosing
Author(s) -
Lima John J.,
Thomas Cameron D.,
Barbarino Julia,
Desta Zeruesenay,
Van Driest Sara L.,
El Rouby Nihal,
Johnson Julie A.,
Cavallari Larisa H.,
Shakhnovich Valentina,
Thacker David L.,
Scott Stuart A.,
Schwab Matthias,
Uppugunduri Chakradhara Rao S.,
Formea Christine M.,
Franciosi James P.,
Sangkuhl Katrin,
Gaedigk Andrea,
Klein Teri E.,
Gammal Roseann S.,
Furuta Takahisa
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.2015
Subject(s) - cyp2c19 , dosing , medicine , proton pump inhibitor , pharmacogenetics , guideline , adverse effect , pharmacokinetics , pharmacology , genotype , cyp2c9 , gastroenterology , cytochrome p450 , pathology , biology , biochemistry , metabolism , gene
Proton pump inhibitors (PPIs) are widely used for acid suppression in the treatment and prevention of many conditions, including gastroesophageal reflux disease, gastric and duodenal ulcers, erosive esophagitis, Helicobacter pylori infection, and pathological hypersecretory conditions. Most PPIs are metabolized primarily by cytochrome P450 2C19 (CYP2C19) into inactive metabolites, and CYP2C19 genotype has been linked to PPI exposure, efficacy, and adverse effects. We summarize the evidence from the literature and provide therapeutic recommendations for PPI prescribing based on CYP2C19 genotype (updates at www.cpicpgx.org ). The potential benefits of using CYP2C19 genotype data to guide PPI therapy include (i) identifying patients with genotypes predictive of lower plasma exposure and prescribing them a higher dose that will increase the likelihood of efficacy, and (ii) identifying patients on chronic therapy with genotypes predictive of higher plasma exposure and prescribing them a decreased dose to minimize the risk of toxicity that is associated with long‐term PPI use, particularly at higher plasma concentrations.