GuidelineClinical pharmacology and therapeutics2014
Clinical Pharmacogenetics Implementation Consortium guidelines for cytochrome P450 2D6 genotype and codeine therapy: 2014 update.
4 registry-linked trialsOpen access · bronzeAbstract readPractice Guideline
In one paragraph
Guideline in Clinical pharmacology and therapeutics, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 301 papers, 5 of them syntheses that pooled it.
0numbers the graph read from it
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301citing papers in PubMed, 5 pooled it
86.0field-weighted citation impact, top 1% of its field
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Implementing Genomics in Practice (IGNITE) Proof of Concept Study: Genotyping in Family Medicine Clinics
A Phase IIA, Prospective, Randomized, Double-blind, Multiple-dose Study of NW-3509A in Chronic Schizoprhenia Patients Not Responding to Their Current Anti-psychotic Medication
NCT04031716 naactive not recruitingnot on this mapstarted 2018, after this paper: background citation
Genetic, Epigenetic, Psychosocial, and Biological Determinants of Post-surgical Pain After Pectus or Spine Surgery
A Prospective Interventional Trial of Pharmacogenomic-Guided Supportive Care in Hematopoietic Cell Transplantation
Who cites it
301 citing papers in PubMed, 5 syntheses or guidelines pooled it, 673 citations in OpenAlex.
- Executive summary of the guideline for prescribing opioid analgesics for chronic non-cancer pain (third edition) by the Japan Society of Pain Clinicians.Journal of anesthesia · 2025Guideline
- Dutch Pharmacogenetics Working Group (DPWG) guideline for the gene-drug interaction between CYP2D6 and opioids (codeine, tramadol and oxycodone).European journal of human genetics : EJHG · 2022Guideline
- Clinical Pharmacogenetics Implementation Consortium Guideline for CYP2D6, OPRM1, and COMT Genotypes and Select Opioid Therapy.Clinical pharmacology and therapeutics · 2021Guideline
- CYP2D6 polymorphism and its impact on the clinical response to metoprolol: A systematic review and meta-analysis.British journal of clinical pharmacology · 2020Pooled it
- Clinical Pharmacogenetics Implementation Consortium Guideline for Cytochrome P450 (CYP)2D6 Genotype and Atomoxetine Therapy.Clinical pharmacology and therapeutics · 2019Guideline
- Hydrocodone vs Oxycodone and Postoperative Pain and Opioid Use in Joint Arthroplasty.JAMA network open · 2026Trial
- Safety, tolerability, pharmacokinetics, and pharmacodynamics of SHR8554, a biased µ-opioid receptor agonist: a phase I trial in healthy volunteers.BMC pharmacology & toxicology · 2026Trial
- CYP2D6-guided opioid therapy for adults with cancer pain: A randomized implementation clinical trial.Pharmacotherapy · 2023Trial
- Pharmacogenetic Guided Opioid Therapy Improves Chronic Pain Outcomes and Comorbid Mental Health: A Randomized, Double-Blind, Controlled Study.International journal of molecular sciences · 2023Trial
- A hybrid implementation-effectiveness randomized trial of CYP2D6-guided postoperative pain management.Genetics in medicine : official journal of the American College of Medical Genetics · 2021Trial
- Examination of Metoprolol Pharmacokinetics and Pharmacodynamics Across CYP2D6 Genotype-Derived Activity Scores.CPT: pharmacometrics & systems pharmacology · 2020Trial
- Effect of magnesium supplementation on emergence delirium and postoperative pain in children undergoing strabismus surgery: a prospective randomised controlled study.BMC anesthesiology · 2020Trial
- Desmetramadol Has the Safety and Analgesic Profile of Tramadol Without Its Metabolic Liabilities: Consecutive Randomized, Double-Blind, Placebo- and Active Comparator-Controlled Trials.The journal of pain · 2019Trial
- Drug-gene and drug-drug interactions associated with tramadol and codeine therapy in the INGENIOUS trial.Pharmacogenomics · 2019Trial
- Tramadol Co-Administration with Oxycodone or Hydrocodone Increases Opioid Burden without Improving Postoperative Pain Control.Clinical pharmacology and therapeutics · 2026Article
- Computational Insights into the Molecular Synergy of Paracetamol and Codeine.Life (Basel, Switzerland) · 2026Article
- Barriers, facilitators, and implementation strategies for pharmacogenomics in community pharmacies: a cross-sectional survey among local champions in pharmacies and key opinion leaders in pharmacogenomics.International journal of clinical pharmacy · 2026Article
- The Environmental and Global Impact of Pharmacogenomics: Advancing Green Pharmacy Toward Sustainable and Inclusive Precision Medicine.Journal of personalized medicine · 2026Review
- Identifying Sex Differences in Adverse Events Reported on Opioid Drugs in the FDA's Adverse Event Reporting System (FAERS).Pharmaceuticals (Basel, Switzerland) · 2026Article
- GenoStaR: An R Package for Genotype to Star Allele Conversion for Major Cytochrome P450 Family of Genes.Clinical pharmacology and therapeutics · 2026Article
241 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors at 7 institutions in 1 country.
K R CrewsDepartment of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
A Gaedigk1] Division of Clinical Pharmacology and Therapeutic Innovation, Children's Mercy Hospitals and Clinics, Kansas City, Missouri, USA [2] Department of Pediatrics, University of Missouri-Kansas City, Kansas City, Missouri, USA.
H M DunnenbergerDepartment of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
J S Leeder1] Division of Clinical Pharmacology and Therapeutic Innovation, Children's Mercy Hospitals and Clinics, Kansas City, Missouri, USA [2] Department of Pediatrics, University of Missouri-Kansas City, Kansas City, Missouri, USA.
T E KleinDepartment of Genetics, Stanford University, Stanford, California, USA.
K E CaudleDepartment of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
C E HaidarDepartment of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
D D Shen1] Department of Pharmaceutics, School of Pharmacy, University of Washington, Seattle, Washington, USA [2] Department of Pharmacy, School of Pharmacy, University of Washington, Seattle, Washington, USA.
J T Callaghan1] Division of Clinical Pharmacology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA [2] Department of Veterans Affairs, RLR VA Medical Center, Indianapolis, Indiana, USA.
S Sadhasivam1] Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA [2] Department of Anesthesia, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
C A Prows1] Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA [2] Division of Patient Services, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
E D KharaschDivision of Clinical and Translational Research, Department of Anesthesiology, Washington University in St. Louis, St. Louis, Missouri, USA.
T C SkaarDivision of Clinical Pharmacology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Clinical Pharmacogenetics Implementation Consortium
St. Jude Children's Research Hospital · USCincinnati Children's Hospital Medical Center · USIndiana University – Purdue University Indianapolis · USUniversity of Missouri–Kansas City · USStanford University · USUniversity of Washington · USWashington University in St. Louis · US
Funding
PharmGKB: pharmacogenomics knowledge for precision medicineR24GM061374 · NIGMS · STANFORD UNIVERSITY · PI ALTMAN, RUSS BIAGIO, KLEIN, TERI ELLEN · 2010 to 2018
$25.2MTAMAXIFEN PHARMACOGENETICSU01GM061373 · NIGMS · INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS · PI FLOCKHART, DAVID ALASTAIR · 2000 to 2009
$17.0MPharmacogenomics of Anti-platlet Intervention-2 (PAPI-2) StudyU01HL105198 · NHLBI · UNIVERSITY OF MARYLAND BALTIMORE · PI SHULDINER, ALAN R. · 2010 to 2014
$13.6MPAARK4Kids-Pharmacogenomics of Anticancer Agents Research in ChildrenU01GM092666 · NIGMS · ST. JUDE CHILDREN'S RESEARCH HOSPITAL · PI RELLING, MARY V · 2010 to 2014
$8.9MIndiana PROSPECTR01HS019818 · AHRQ · INDIANA UNIVERSITY INDIANAPOLIS · PI DEXTER, PAUL · 2010 to 2010
$8.4MMETHADONE AND HIV DRUG INTERACTIONSR01DA014211 · NIDA · WASHINGTON UNIVERSITY · PI KHARASCH, EVAN D. · 2001 to 2012
$4.8MRegulation of drug metabolizing enzymes by miRNAsR01GM088076 · NIGMS · INDIANA UNIVERSITY INDIANAPOLIS · PI SKAAR, TODD C. · 2009 to 2017
$3.8MExogenous and Endogenous Biomarkers of CYP2D6 Variability in PediatricsR01HD058556 · NICHD · CHILDREN'S MERCY HOSP (KANSAS CITY, MO) · PI LEEDER, JAMES STEVEN, LIN, YVONNE SARAH · 2010 to 2014
$2.7MADDICTION THERAPY: METABOLISM AND TRANSPORT-MEDIATED DRUG INTERACTIONSR01DA025931 · NIDA · WASHINGTON UNIVERSITY · PI KHARASCH, EVAN D. · 2008 to 2012
$1.7MAHRQ HHS R01 HS019818AHRQ HHS R01 HS19818-01NHLBI NIH HHS U01 HL105198NICHD NIH HHS R01 HD058556NIDA NIH HHS R01 DA014211NIDA NIH HHS R01 DA025931NIDA NIH HHS R01-DA14211NIDA NIH HHS R01 DA25931NIGMS NIH HHS R01 GM088076NIGMS NIH HHS R24 GM061374NIGMS NIH HHS R24-GM61374NIGMS NIH HHS U01 GM061373NIGMS NIH HHS U01 GM092666
Abstract
Codeine is bioactivated to morphine, a strong opioid agonist, by the hepatic cytochrome P450 2D6 (CYP2D6); hence, the efficacy and safety of codeine are governed by CYP2D6 activity. Polymorphisms are a major cause of CYP2D6 variability. We summarize evidence from the literature supporting this association and provide therapeutic recommendations for codeine based on CYP2D6 genotype. This document is an update to the 2012 Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines for CYP2D6 genotype and codeine therapy.
Indexed as
PharmacogeneticsAnalgesics, OpioidCodeineCytochrome P-450 CYP2D6Genetic TestingGenotypeHumansMorphinePolymorphism, GeneticAnalgesics, OpioidCodeineCytochrome P-450 CYP2D6Morphine
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Registered trials
NCT02335307ClinicalTrials.gov
NCT02624167ClinicalTrials.gov
NCT04031716ClinicalTrials.gov
NCT04727827ClinicalTrials.gov
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.