Codeine Intoxication Associated with Ultrarapid CYP2D6 Metabolism
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- 30 December 2004
- journal article
- research article
- Published by Massachusetts Medical Society in New England Journal of Medicine
- Vol. 351 (27) , 2827-2831
- https://doi.org/10.1056/nejmoa041888
Abstract
Life-threatening opioid intoxication developed in a patient after he was given small doses of codeine for the treatment of a cough associated with bilateral pneumonia. Codeine is bioactivated by CYP2D6 into morphine, which then undergoes further glucuronidation. CYP2D6 genotyping showed that the patient had three or more functional alleles, a finding consistent with ultrarapid metabolism of codeine. We attribute the toxicity to this genotype, in combination with inhibition of CYP3A4 activity by other medications and a transient reduction in renal function.Keywords
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