GuidelineClinical pharmacology and therapeutics2024
Clinical Pharmacogenetics Implementation Consortium Guideline for CYP2B6 Genotype and Methadone Therapy.
Guideline in Clinical pharmacology and therapeutics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Efficacy and safety of intravenous methadone for pain management in cardiac surgery: a systematic review and meta-analysis.Frontiers in medicine · 2026Pooled it
- Methadone administration and QT interval prolongation: protocol for a systematic review and meta-analysis.BMJ open · 2026Article
- Impact of CYP Enzyme Polymorphisms on Opioid Response in Anesthesia and Pain Medicine.Pain research & management · 2026Review
- Applicability domain-expansion studies for machine learning models reveal new inhibitors of CYP2B6.Drug metabolism and disposition: the biological fate of chemicals · 2025Article
- The Role of Pharmacogenetic Biomarkers in Pain.Biomedicines · 2025Article
- Tailored Therapies in Addiction Medicine: Redefining Opioid Use Disorder Treatment with Precision Medicine.Journal of personalized medicine · 2025Review
- The Relevance of Pharmacokinetic Biomarkers in Response to Methadone Treatment: A Systematic Review.Pharmaceuticals (Basel, Switzerland) · 2025Review
- Part 1: Evaluation of Pediatric Cannabis-Drug Interaction Reports.Pharmacology research & perspectives · 2025Review
- Impact of Genetic Variants on Pregabalin Pharmacokinetics and Safety.Pharmaceuticals (Basel, Switzerland) · 2025Article
- Pharmacogenomics to Improve Supportive Care Symptoms. A Prospective Observational Study Protocol.NIHR open research · 2025Article
- The Value of Clinical Pharmacogenomic Guidelines That Recommend Standard of Care Over Genotype-Based Prescribing.Clinical pharmacology and therapeutics · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
17 authors.
Funding
Abstract
Methadone is a mu (μ) opioid receptor agonist used clinically in adults and children to manage opioid use disorder, neonatal abstinence syndrome, and acute and chronic pain. It is typically marketed as a racemic mixture of R- and S-enantiomers. R-methadone has 30-to 50-fold higher analgesic potency than S-methadone, and S-methadone has a greater adverse effect (prolongation) on the cardiac QTc interval. Methadone undergoes stereoselective metabolism. CYP2B6 is the primary enzyme responsible for catalyzing the metabolism of both enantiomers to the inactive metabolites, S- and R-2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (S- and R-EDDP). Genetic variation in the CYP2B6 gene has been investigated in the context of implications for methadone pharmacokinetics, dose, and clinical outcomes. Most CYP2B6 variants result in diminished or loss of CYP2B6 enzyme activity, which can lead to higher plasma methadone concentrations (affecting S- more than R-methadone). However, the data do not consistently indicate that CYP2B6-based metabolic variability has a clinically significant effect on methadone dose, efficacy, or QTc prolongation. Expert analysis of the published literature does not support a change from standard methadone prescribing based on CYP2B6 genotype (updates at www.cpicpgx.org).
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.