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The pharmacogenetics of codeine pain relief in the postpartum period

The Pharmacogenomics Journal volume 15, pages 430–435 (2015)Cite this article

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Abstract

The objective of this study was to examine interindividual variability in codeine requirements and pain management by examining select genetic polymorphisms in the codeine pharmacological pathway. The study included a nested cohort of 98 women who were prescribed codeine following cesarean section. Participants were genotyped for select polymorphisms of the COMT, ABCB1, CYP2D6, UGT2B7 and OPRM1 genes and instructed to describe their level of pain using the visual analog scale (mm) 1 h following each dose of codeine. Analysis revealed that reported pain increases with maternal age (P=0.041). Asians required more codeine than Caucasians (P=0.048). Significant differences in mean dose consumption were seen among the genotypic groups of the OPRM1 A118G (P=0.001) and UGT2B7 C802T (P=0.015) variants. These variants were found to predict codeine consumption in the cohort overall (P=0.000) and among Caucasians (P=0.001). These findings will assist in customizing therapy to effectively manage postpartum pain.

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Author information

Authors and Affiliations

  1. Division of Clinical Pharmacology and Toxicology, Department of Pediatrics, The Motherisk Program, Hospital for Sick Children, Toronto, Ontario, Canada

    M Baber, S Chaudhry & G Koren

  2. Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada

    M Baber & G Koren

  3. Peter Gilgan Centre for Research and Learning, Hospital for Sick Children, Toronto, Ontario, Canada

    M Baber, L Kelly & G Koren

  4. Centre for Molecular Medicine and Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada

    C Ross & B Carleton

  5. Child and Family Research Institute, Vancouver, British Columbia, Canada

    B Carleton

  6. Department of Obstetrics and Gynecology, St Michael’s Hospital, Toronto, Ontario, Canada

    H Berger

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  1. M Baber
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  2. S Chaudhry
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Correspondence to G Koren.

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Competing interests

CR, CB and GK are supported by grants from the Canadian Institutes for Health Research (CIHR), the Canadian Foundation for Innovation (CFI), the Canadian Pharmacogenomics Network for Drug Safety (CPNDS), Genome British Columbia and the Child & Family Research Institute (CFRI). MB has been awarded a University of Toronto Fellowship Award.

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The sponsors have no role in the design of this study; collection, analysis and interpretation of the data; writing of this manuscript or the decision to submit this manuscript for publication. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest/conflict in the subject matter. No writing assistance was utilized in the production of this manuscript.

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Baber, M., Chaudhry, S., Kelly, L. et al. The pharmacogenetics of codeine pain relief in the postpartum period. Pharmacogenomics J 15, 430–435 (2015). https://doi.org/10.1038/tpj.2015.3

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