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The analysis also showed that patients identified as reduced metabolizers were fivefold more likely to be switched than patients identified as ultra metabolizers, and intermediate metabolizes had a 50% higher switching rate than ultra metabolizers.
In ultrarapid metabolizers, a greater concentration of O-desmethyltramadol is excreted into breast milk.
The recommended starting dosage of deutetrabenazine is 6 mg twice daily taken with food, increasing by 6 mg/d weekly as needed, with a maximum dose of 48 mg/d or 36 mg/d in those taking strong CYP2D6 inhibitors or who are 2D6 poor metabolizers.
Northern African and middle eastern populations show higher prevalence of ultra-rapid CYP2D6 metabolizers (12), the same ethnicity that the aforementioned player possessed.
At the time that the CAP PGX survey was constructed, the FDA CDER was considering a relabeling initiative for the prodrug tamoxifen, based on retrospective clinical studies such as those of Goetz et al, (5) who showed that patients with breast cancer who were wild type for CYP2D6 had longer disease-free survival than women who were poor metabolizers (eg, *4/*4).
3-5) From drug related genetic pattern, the human gene are sub-grouped into few phenotypes of poor (or slow) metabolizers (PM), intermediate metabolizers (IM), extensive (or rapid) metabolizers (EM), and ultrarapid metabolizers (UM).
People who break down caffeine rapidly decrease their risk of a heart attack by drinking coffee, while slow caffeine metabolizers dramatically increase their risk
The maximum recommended dose of citalopram is 20 mg per day for patients who have hepatic impairment, are older than age 60, are CYP 2C19 poor metabolizers, or are taking cimetidine (Tagamet) or another CYP2C19 inhibitor.
Those clearing caffeine quickly (so called fast metabolizers) may gain heart-protective effects from caffeine, while those who are slow metabolizers may have increased risk.
Hence the low metabolizers are more susceptible towards genotoxicity.
With a drug such as caffeine, for example, one population of people might be fast metabolizers, while another might metabolize the drug more slowly," Green explained.