Clinical pharmacogenetics implementation consortium guidelines for CYP2C9 and HLA-B genotypes and phenytoin dosing.

Caudle KE1, Rettie AE2, Whirl-Carrillo M3, Smith LH4, Mintzer S5, Lee MT6, Klein TE3, Callaghan JT7; Clinical Pharmacogenetics Implementation Consortium.

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Abstract

Phenytoin is a widely used antiepileptic drug with a narrow therapeutic index and large interpatient variability, partly due to genetic variations in the gene encoding cytochrome P450 (CYP)2C9 (CYP2C9). Furthermore, the variant allele HLA-B*15:02, encoding human leukocyte antigen, 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 recommendations for the use of phenytoin based on CYP2C9 and/or HLA-B genotype (also available on PharmGKB: http://www.pharmgkb.org). The purpose of this guideline is to provide information for the interpretation of HLA-B and/or CYP2C9 genotype tests so that the results can guide dosing and/or use of phenytoin. Detailed guidelines for the use of phenytoin as well as analyses of cost-effectiveness are out of scope. Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines are periodically updated at http://www.pharmgkb.org.

PMID:: 25099164; [PubMed - indexed for MEDLINE]
PMCID:: PMC4206662

Free PMC Article

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National Guideline Clearinghouse | Clinical Pharmacogenetics Implementation Consortium guidelines for <em>CYP2C9</em> and <em>HLA-B</em> genotypes and phenytoin dosing.

Clinical Pharmacogenetics Implementation Consortium

Guideline Title

Clinical Pharmacogenetics Implementation Consortium guidelines for CYP2C9 and HLA-B genotypes and phenytoin dosing.

Bibliographic Source(s)

Caudle KE, Rettie AE, Whirl-Carrillo M, Smith LH, Mintzer S, Lee MT, Klein TE, Callaghan JT. Clinical pharmacogenetics implementation consortium guidelines for CYP2C9 and HLA-B genotypes and phenytoin dosing. Clin Pharmacol Ther. 2014 Nov;96(5):542-8. [36 references] PubMed External Web Site Policy