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Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for <i>CYP2C9</i> and <i>HLA‐B</i> Genotypes and Phenytoin Dosing: 2020 Update

2020/08/12 by Jason H. Karnes, Allan E. Rettie, Andrew A. Somogyi +13 · 26 citations
Medicine · Pharmacology, Toxicology and Pharmaceutics · #Drug-Induced Adverse Reactions #Pharmaceutical studies and practices #Pharmacovigilance and Adverse Drug Reactions

paper · pdf · doi:10.1002/cpt.2008

Abstract

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).

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