Cytochrome P450 2D6 gene polymorphism and safety of combination use of metoprolol and propafenone
10.3760/cma.j.cn114015-20220223-00148
- VernacularTitle:细胞色素P450 2D6基因多态性与美托洛尔和普罗帕酮联用的安全性
- Author:
Xue LI
1
;
Qingxia ZHANG
;
Chunlin YIN
Author Information
1. 首都医科大学宣武医院心脏内科，国家老年疾病临床医学研究中心，北京 100053
- Publication Type:Journal Article
- Keywords:
Metoprolol;
Propafenone;
Drug interactions;
Genes;
Cytochrome P-450 CYP2D6;
Drug-related side effects and adverse reactions
- From:
Adverse Drug Reactions Journal
2022;24(7):365-370
- CountryChina
- Language:Chinese
-
Abstract:
Metoprolol and propafenone are commonly used drugs in cardiovascular diseases. Both drugs are metabolized by liver cytochrome P450 (CYP) 2D6. However, propafenone is not only a CYP2D6 substrate, but also a CYP2D6 inhibitor, which may interact with metoprolol and cause adverse reactions. This interaction also depends on CYP2D6 genotype. For patients with CYP2D6 phenotypes of poor metabolizer (PM) and intermediate metabolizer (IM), the combination with propafenone can increase plasma concentration of metoprolol due to the inhibition of propafenone on CYP2D6. Therefore, the combination of metoprolol and propafenone should be avoided as far as possible. For the patients who need the combined treatment with the 2 drugs, attention should be paid to the monitoring of blood pressure, heart rate, and electrocardiogram changes during medication. If possible, CYP2D6 genotype should be detected and the drug dose should be adjusted according to the test results.
