Q. I learned from analysis of my DNA that I cannot efficiently metabolize many medications. It’s unfortunate that our doctors don’t usually recommend this type of testing that could help so many.
I took the initiative and paid for the testing myself. It has paid off many times over. My guess is that some people who experience severe side effects from their medicine have a similar DNA structure that makes them poor metabolizers (low or inefficient CYP2D6).
A. The enzyme known as cytochrome P450 2D6 helps to metabolize approximately one-fourth of the drugs in common use. There is a lot of genetically determined variability in the amount of this enzyme we make. Some people churn out lots, and are able to clear these drugs from their bloodstream quickly. Others make little or none. When they take such a medication, blood levels may be high for a longer period of time, leading to a higher risk of side effects.
Since you know your genetic profile, you should ask your doctor to check on any new prescription to see if it is metabolized by CYP2D6. Some of the drugs affected include antidepressants (fluoxetine, paroxetine, sertraline, venlafaxine), powerful pain relievers (hydrocodone, oxycodone, tramadol), beta blockers (carvedilol, metoprolol, propranolol) and the cough medicine dextromethorphan (the DM in OTC cough syrup). If you must take a drug that is metabolized by CYP2D6, you should request the lowest possible dose, at least at the beginning.
