MedicineGeneticsPharmacologyMedical GeneticsPharmacogeneticsPharmacogenomicsCytochrome P450 EnzymesCytochrome P450-mediated MetabolismDrug Metabolism GeneticsGenetic DisordersPopulation PharmacogeneticsPopulation PharmacogenomicsCyp2d6 Drug MetabolismCyp2d6 GenotypeCyp2d6 PharmacogeneticsCytochrome P450 2D6Cytochrome P450 Genetic PolymorphismGenetic PolymorphismsMetoclopramide Therapy
BACKGROUND: Extrapyramidal syndromes (EPS) are clinically relevant side effects of metoclopramide which are often not anticipated. PATIENTS AND METHODS: Two patients who received metoclopramide developed an acute dystonic reaction. Symptoms disappeared after biperiden or trihexyphenidyl were given. Molecular analysis of the CYP2D6 gene was performed using a PCR-based method. RESULTS: Both patients were homozygous for inactive CYP2D6 alleles (CYP2D6*4/*4 and CYP2D6*4/*5), which are associated with slow drug metabolism. CONCLUSION: Metoclopramide-induced acute dystonic reactions may occur in patients carrying a CYP2D6 genetic polymorphism.
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Ulrike M. Stamer, Katja Lehnen, Fabienne Höthker et al. · Pain · 2003 · 333 citations
Extrapyramidal reactions with metoclopramide.
D. Nicholas Bateman, M. D. Rawlins, Judy M. Simpson · BMJ · 1985 · 228 citations · Full text