CPIC® Guideline for Beta-blockers and CYP2D6, ADRB1, ADRB2, ADRA2C, GRK4, and GRK5

Most recent guideline publication:

Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for CYP2D6, ADRB1, ADRB2, ADRA2C, GRK4, and GRK5 Genotypes and Beta-Blocker Therapy (July 2024)

Tables and figure provided in the main manuscript of the guideline:

Table 1. Assignment of predicted CYP2D6 phenotypes based on genotypes

Table 2. Dosing recommendations for metoprolol based on CYP2D6 phenotype

Supplement to: Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for CYP2D6, ADRB1, ADRB2, ADRA2C, GRK4, and GRK5 Genotypes and Beta-Blocker Therapy (July 2024)

Tables and figures included in the supplement^a or referenced in the guideline:

Table S1. Pharmacologic Properties of orally administered Beta-Blockers included in this guideline

Table S2. Evidence linking CYP2D6 Genetic Variation to Beta-Blocker phenotype

Table S3. Evidence linking ADRB1 Genetic Variation to Beta-Blocker phenotype

Table S4. Evidence linking ADRB2 Genetic Variation to Beta-Blocker phenotype

Table S5. Evidence linking ADRA2C Genetic Varitaion to Beta-Blocker phenotype

Table S6. Evidence linking GRK4/5 Genetic Variation to Beta-Blocker phenotype

Table S7. Evidence linking ADRB1, ADRB2, ADRA2C, and GRK4/5 Genetic Variant combinations to Beta-Blocker phenotype

Table S8. Dosing Recommendations for Carvedilol Based on CYP2D6 Phenotype

Table S9. Dosing Recommendations for Acebutolol, Betaxolol, Bisoprolol, and Propranolol Based on CYP2D6 Phenotype

Table S10. Dosing Recommendations for Nebivolol based on CYP2D6 Phenotype

Figure S1. Metoprolol Pathway, Pharmacokinetics

Figure S2. Beta-Agonist/Beta-Blocker Pathway, Pharmacodynamics

CYP2D6 allele definition table

CYP2D6 allele functionality table

CYP2D6 frequency table

CYP2D6 diplotype-phenotype table

Gene Resource Mapping CYP2D6 gene resource mappings

Drug Resource Mapping Metoprolol

Clinical Decision Support:bImplementation workflow CYP2D6 consult Metoprolol pre- and post-test alerts and flow chart

^aSome of the tables included in the guideline may have been updated on-line, particularly to reflect newly described or newly characterized alleles. These include the gene-specific information tables (https://www.pharmgkb.org/page/pgxGeneRef) that support CPIC guidelines by providing information regarding star (*) allele definitions, allele function, allele frequency by major ethnic groups, translations of diplotype to phenotype, and gene resource mappings. ^bThese resources support the adoption of CPIC guidelines into the electronic health record with clinical decision support and provide information that clinical implementers find helpful.