Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for CYP2C9 and HLA-B Genotypes and Phenytoin Dosing: 2020 Update

Jason H. Karnes, Allan E. Rettie, Andrew A. Somogyi, Rachel Huddart, Alison E. Fohner, Christine M. Formea, Ming Ta Michael Lee, Adrian Llerena, Michelle Whirl-Carrillo, Teri E. Klein, Elizabeth J. Phillips, Scott Mintzer, Andrea Gaedigk, Kelly E. Caudle, John T. Callaghan

Research output: Contribution to journalReview articlepeer-review

101 Scopus citations

Abstract

Phenytoin is an antiepileptic drug with a narrow therapeutic index and large interpatient pharmacokinetic variability, partly due to genetic variation in CYP2C9. Furthermore, the variant allele HLA-B*15:02 is associated with an increased risk of Stevens–Johnson syndrome and toxic epidermal necrolysis in response to phenytoin treatment. We summarize evidence from the published literature supporting these associations and provide therapeutic recommendations for the use of phenytoin based on CYP2C9 and/or HLA-B genotypes (updates on cpicpgx.org).

Original languageEnglish (US)
Pages (from-to)302-309
Number of pages8
JournalClinical Pharmacology and Therapeutics
Volume109
Issue number2
DOIs
StatePublished - Feb 2021

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

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