Pharmacogenetics (or pharmacogenomics) is the study of genetic differences in drug metabolic pathways which can affect individual responses to drugs, both in terms of therapeutic effect as well as side effects. In the Netherlands pharmacists can request the available pharmacogenetic data if the patient has given consent. The recommendations per gene-drug combination can be interpreted by the healthcare professional to adjust the dose or select an alternative drug.
Recommendations
In the Netherlands the pharmacogenetic recommendation text is incorporated in the G-Standaard and can be used during prescribing and dispensing. For healthcare professionals outside the Netherlands, we provide the short recommendation text and literature list below. This file is updated after every meeting of the Dutch Pharmacogenetic Working Group of the KNMP.
- Recommendation_text_pharmacogenetics_20211109.pdf Downloaden
For every enzyme (gene) general background information is available. Here you can find information about pharmacogenetics in general and information about the variants of the specific enzyme.
General background information
- CYP1A2 English.pdf Downloaden
- CYP2B6 English.pdf Downloaden
- CYP2C9 English.pdf Downloaden
- CYP2C19 English.pdf Downloaden
- CYP2D6 English.pdf Downloaden
- CYP3A4 English.pdf Downloaden
- CYP3A5 English.pdf Downloaden
- DPD English.pdf Downloaden
- NUDT15 English.pdf Downloaden
- MTHFR English.pdf Downloaden
- HLA English.pdf Downloaden
- VKORC1 English.pdf Downloaden
- UGT1A1 English.pdf Downloaden
- TPMT English.pdf Downloaden
- SLCO1B1 English.pdf Downloaden
- ABCG2 English.pdf Downloaden
- Uncertainties in genotyping results.pdf Downloaden
Algorithms
Acenocoumarol and phenprocoumon algorithm
Variants in CYP2C9 and VKORC1 are relevant for the loading- and maintenance dose of coumarins. In the EU-PACT study algorithms are used for acencoumarol, phenprocoumon and warfarin (warfarin in barely used in the Netherlands). The algorithm provides a more accurate estimate of the dose than the seperate pharmacogenetic recommendations for CYP2C9 and VKORC1; the recommendations refer to these algorithms.
- Acenocoumarol and phenprocoumon algorithm.xlsx Downloaden
Warfarin doses day 4 and 5 - calculation for different genotypes
Variants in CYP2C9 and VKORC1 are relevant for the loading- and maintenance dose of coumarins. In the EU-PACT study algorithms are used for acencoumarol, phenprocoumon and warfarin (warfarin in barely used in the Netherlands). The algorithm provides a more accurate estimate of the dose than the seperate pharmacogenetic recommendations for CYP2C9 and VKORC1; the recommendations refer to these algorithms.
- Warfarin doses day 4 and 5 - calculation for different genotypes.xlsx Downloaden
Warfarin loading doses - calculation for different genotypes
Variants in CYP2C9 and VKORC1 are relevant for the loading- and maintenance dose of coumarins. In the EU-PACT study algorithms are used for acencoumarol, phenprocoumon and warfarin (warfarin in barely used in the Netherlands). The algorithm provides a more accurate estimate of the dose than the seperate pharmacogenetic recommendations for CYP2C9 and VKORC1; the recommendations refer to these algorithms.
- Warfarin loading doses calculation for different genotypes.xlsx Downloaden