Journal
POSTGRADUATE MEDICAL JOURNAL
Volume 80, Issue 940, Pages 107-109Publisher
BMJ PUBLISHING GROUP
DOI: 10.1136/pmj.2003.006478
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Drug metabolism may be perturbed by genetically determined differences in the metabolic activity of cytochrome P450 enzymes. The authors encountered extensive bleeding in a patient receiving warfarin for anticoagulation after the introduction of celecoxib, an anti-inflammatory drug. As the CYP2C9 enzyme metabolises these drugs, it was determined whether variant alleles were responsible for altering warfarin handling. Genetic analysis established that the patient was a compound heterozygote with CYP2C9* 2 and * 3 variant alleles, which exhibit lower drug metabolising capacity and enhance susceptibility to drug toxicity.
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