Table 2.

CYP2D6 phenotypes and the therapeutic recommendations for propafenone therapy, from The Dutch Pharmacogenetics Working Group (2016)

CYP2D6 PhenotypeRecommendations for propafenone therapy
Ultrarapid metabolizerInsufficient data to allow calculation of dose adjustment. Adjust dose in response to plasma concentration and record ECG or select alternative drug (e.g., sotalol, disopyramide, quinidine, amiodarone).
Intermediate metabolizerInsufficient data to allow calculation of dose adjustment. Adjust dose in response to plasma concentration and record ECG or select alternative drug (e.g., sotalol, disopyramide, quinidine, amiodarone).
Poor metabolizerReduce dose by 70%, record ECG, monitor plasma concentration

The level of evidence for the therapeutic (dose) recommendations is 4/4 (“good quality”) for poor metabolizers, and 3/4 (“moderate quality”) for intermediate and ultrarapid metabolizer types. The Table is adapted from Swen J.J., Nijenhuis M., de Boer A., Grandia L. et al. Pharmacogenetics: from bench to byte - an update of guidelines. Clinical pharmacology and therapeutics. 2011;89(5):662–73 (2, 3).

From: Propafenone Therapy and CYP2D6 Genotype

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