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Table 1 Clinically relevant pharmacogenomic targets for pain management

From: Pharmacogenomic considerations in the opioid management of pain

Gene Variant Analgesics affected Consequence of genetic variation
ABCB1 3435C>T Morphine Homozygous variants cause increased efficacy
CYP2D6 1846G>A, 2549A>del Codeine, oxycodone, tramadol Poor metabolizers (PM; variants) have more adverse drug reactions and less efficacy
UGT2B7 -840G>A, 802C>T; *2 Morphine Homozygous variants require lower doses of morphine for efficacy; UGT2B7*2 variants have less side effects (nausea) with morphine
COMT 1947G>A, (Rs4680) Morphine Homozygous variants have a three- to fourfold decrease in COMT activity; wild-type patients require higher doses of morphine for efficacy than variant patients
OPRM1 118A>G Morphine, M6G Homozygous variants cause decreased effectiveness and increased dose requirements