Cytochrome P-450 2B6 Genotyping & Prescription Medication
CYP2B6 is part of a family of genes that produce enzymes our bodies use to break down medications. CYP2B6 is found in the liver and metabolizes almost a tenth of all the common prescription medications. These medications include artemisinin, bupropion (Wellbutrin SR®), cyclophosphamide, efavirenz (Sustiva®), ketamine, and methadone (Dolophine®). Although this enzyme is found most commonly in the liver, it is also detected in brain tissue, with the kidneys, and within the intestine. There are a variety of factors that affect CYP2B6 production and behavior. One of the chief factors is an individual’s unique genetics.
The Link Between Genetics and CYP2B6 Metabolization
All of the enzymes in the cytochrome p-450 family are important in breaking down and metabolizing medications. In pharmacogenetic studies, patients are categorized based on how well their body can metabolize a medication. There are six categories from poor metabolizers to ultra-rapid metabolizers. To date, more than 250 prescription medications now list pharmacogenetic information on their labels. Understanding how genetics influences CYP2B6 informs how an individual patient may react to any of the aforementioned medications.
Pharmacogenetic Testing for Depression Medication Including Wellburtin SR®
As mentioned above CYP2B6 affects how a patient interacts with medications like Wellburtin SR. Wellburtin SR is a psychiatric medication used for treating clinical depression. Anxiety and depression medications have a reputation for requiring months of trial and error. Pharmacogenetic testing can decrease the time it takes for physicians to find the right medication and the right dosage for their patients. More importantly, PGx testing can prevent adverse reactions in patients.
PGx Testing for HIV/AIDs Medication
CYP2B6 has also been linked to HIV/AIDs medications including Sustiva. Patients who are either taking Sustiva or are going to begin treatment should consider asking their physician if PGx testing would be right for them. Pharmacogenetics could provide valuable insights that could prevent adverse reactions or inefficacy. Physicians should use their best judgement when deciding if a patient is a good fit for PGx testing.
Other Factors To Consider
Cytochrome P-450 enzymes are affected by an individual’s genetics. However, there are other factors that influence the production and behavior of these enzymes. This is especially relevant for CYP2B6 which is considered to be one of the most polymorphic genes in the CYP family. Aside from genetic variation from person to person, within an individual’s lifetime their own bodies can alter how these enzymes are produced and behave. That being said, understanding an individual’s genetics is invaluable when prescribing medications that are affected by these enzymes.