Naslov
CYP2D6 *6/*6 genotype and drug interactions as cause of haloperidol induced extrapyramidal symptoms

Autori
Šimić, Iveta ; Potočnjak, Ines ; Kraljičković, Iva ; Stanić Benić, Mirjana ; Čegec, Ivana ; Juričić Nahal, Danica ; Ganoci, Lana ; Božina, Nada

Izvornik
Pharmacogenomics (1462-2416) 17 (2016), 13; 1385-1389

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
adverse drug reactions ; ciprofloxacin ; drug interactions ; haloperidol ; ­pharmacogenetics

Sažetak
A 66-year-old male Caucasian, received 1 mg of haloperidol orally and rapidly developed severe iatrogenic extrapyramidal symptoms. Treatment was immediately discontinued, and the side effects resolved. Haloperidol is mainly metabolized by Phase I CYP2D6 and to the lesser extent by CYP3A4 and by Phase II UGT2B7 enzymes. Genotyping was performed revealing CYP2D6*6/*6, CYP3A4*1/*1, and UGT2B7 -161 C/T genotypes, implicating poor, extensive and intermediate metabolism, respectively. Of the CYPs, haloperidol is metabolized by CYP2D6 and CYP3A4 primarily. It was the introduction of ciprofloxacin which was a trigger for the development of adverse drug reaction due to inhibition of CYP3A4, which was in presented patient main metabolic pathway for haloperidol since he was CYP2D6 poor metabolizer. Presented case report highlights the importance of genotyping. Pharmacogenetics testing should be considered when drug toxicity is suspected, polymorphic metabolic pathways used and drugs concomitantly applied.

Izvorni jezik
Engleski

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